Client Packet
Vetek Chic On Wheels.
Your Neighborhood Pet Sitter and In-Home Medical Health Assistant.
Telephone: 602-359-3693 Website: www.vetekchiconwheels.com Email: Vetek Chic@gmail.com
Pet Based Network Group: www.azpetprofessionals.com.
Thank you for choosing Vetek Chic On Wheels (VCOW) to assist you with your pet needs!
Due to the Nature of today’s Service Industry and Legal System, it is imperative that I have signed legal forms. I apologize for the
inconvenience this may cause you. Most of my correspondence is through the Internet, Email, QuickBooks or Text Messaging. Please
let me know if you would like another means to correspondence.
INSTRUCTIONS:
Please print one copy of this New Client Packet and complete in blue or colored ink. This packet can be printed in black and
white. Please have forms completed and printed prior to Initial Visit. I will bring an additional copy of the Policies for you to
keep.
The New Client Packet includes: pgs. 2-9 Client Information, Basic Information, Policies, Key Agreement,
Veterinary Release, Model Release and Hire Dates. Pgs. 10-11are only for Medical and Taxi. Diabetic injections
included. (Pg. 10)
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Pages 1-9 must be printed or emailed, and filled out in full.
Pages 10-11 need to be printed and filled out only if you have hired me for Medical Assistance or Taxi Services.
Please have these items completed and printed out at our initial Meet and Greet Visit.
1.
2.
3.
4.
5.
YOUR SIGNED DOCUMENTS (THIS PACKET)
ANY SPECIAL INSTRUCTIONS THAT MAY NOT BE INCLUDED IN THIS PACKET
YOUR PET’S MEDICAL RECORDS (INCLUDING VACCINE HISTORY) OR IN THE VERY LEAST, THE TELEPHONE
NUMBER OF YOUR VET IN CASE THEY ARE NEEDED.
A CURRENT RABIES LICENSE FOR DOGS UNLESS YOUR VET HAS REQUESTED NO VACCINES DUE TO ILLNESS OR
OTHER FACTOR. IT IS NOT REQUIRED IN THE STATE OF ARIZONA FOR CATS TO BE VACCINATED OR LICENSED
FOR RABIES, HOWEVER FOR THE SAFETY OF OTHERS AS WELL AS YOUR CAT, IT IS HIGHLY RECOMMENDED IF
YOUR PET IS UNPREDICTABLE IN NATURE AND TEMPERMANT.
A SET OF TWO KEYS (If I am providing service to you while you are away from home)
(I will provide a keychain and a code (no name will be put on your key) see “KEY AGREEMENT” FOR IMPORTANCE
PAYMENTS ACCEPTED:

CASH

PAY PAL: THROUGH WEBSITE ONLY AND ONLY FOR INITIAL “MEET AND GREET” (www.vetekchiconwheels.com)

CREDIT CARDS: VISA, MASTER CARD AND DISCOVER (AT MEET AND GREET)
If paying by Credit Card, I will take payment at your home during our Meet and Greet. You will see charges on your Credit Card
Invoice that state Vetek Chic On Wheels. You will also be emailed a PAID Invoice through Quick Books.
Would you like an update on your pet while you are away? I am able to send Email, or Text Msgs. via my Blackberry.
Please indicate if you wish to receive an update and how.
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Cell phone: please enter cell number: TEXT MSG. OR VOICE? (regular charges may apply from your carrier)
Email: please enter email address:
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Would you allow me to post pictures of your pet on my personal websites or Print you Daily Report Cards with your pets
Picture/s? If yes, please sign Model Release on page 12. None of your personal information will be shown or mentioned.
You can see your pet’s posted pictures at www.http://vetekchiconwheels.shutterfly.com. Once there, you will be able to
purchase pictures through Kodak if you choose! Thank you!
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
OWNER INFORMATION
Mr./Mrs./Ms.
FIRST NAME:
LAST NAME:
HOME PHONE:
CELL PHONE #1:
CELL #2:
WORK PHONE:
Major Cross Roads:
Complete Address:
EMAIL ADDRESS:
Emergency Contact name:
Emergency #:
Referred by:
In- Home without Owner present: (NA if not Applicable)
Security System:
Alarm Company Name:
Code:
Phone Number:
Password:
Arming Instructions:
Disarming Instructions:
Door Entering (must be near alarm):
In Home without Owner present:
Property Description:
Securely Fenced: Yes  No 
Invisible Fence:
Yes 
No 
Gate Properly Working:
Yes 
No 
Pet Door:
Yes 
No 
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Describe any problems with the fence (i.e. gate not easily latched, dog digs under fence, etc:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
BASIC INFORMATION AND CHECK LIST
(Must be filled out prior to meet and greet as I will take it with me)
1. Location of cleaning supplies (solvents, broom, dustpan, paper towels, litter, food and water bowls,
garbage bags, Muddy Paw Towels or Rags, Carpet Spot Cleaner, or Cleaning Machine. Best to have
out. Please understand how important it is to have cleaning supplies handy, as I DO NOT carry my
own.
2. Location of Leash, Harness and Crate:
3. Is your pet familiar with walking on a leash and riding in a crate:
(please leave crate out in case of emergency travel needed)
Yes 
No 
If no, please describe:
4. Does your pet stay in a crate, have run of the house/doggy door or stay outside:
5. Can you leave a radio out for soft music? TV? Remote Control?
6. Treats, Chewies, Toys, Kongs, Brushes and Combs
7. If you have any plants that you would like watered, please place them on a waterproof surface and
instructions.
8. I can: pick up newspapers, leave on certain lights in the evening, pull down shades, etc.. Please leave
instructions:
9. Additional Contact Numbers: (Hotel, Home where you are staying)
10. Any special Last Minute Notes/Instructions
11. Location of Emergency Shut Off Switches: Gas:
Water:
Breaker
***If your pet likes Children, would you allow my children to accompany on an occasional visit? My family is completely covered
by my insurance policy and they have strict rules when they accompany me!
Yes No
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Please feel free to call me anytime for an update! I will return your call the same day. If you do not hear back from me within 24 hours, please
try again- voicemails and technology in it entirety, sometimes do get lost. Emails are welcome and I check them throughout the day. I have
Unlimited Texting Available through my Black Berry Service so do not be afraid to Text me as often as you’d like.
Signed this day:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
VETEK CHIC ON WHEELS POLICIES
1. The term, Client, Owner, Pet Owner or Customer are synonymous with the person contracting services for one
or more domestic animals.
2. Vetek Chic On Wheels and its employees, if any, agree to provide services stated in this contract in a reliable
and trustworthy manner. In consideration of these services and as an express condition thereof, the client
expressly waives any and all claims against Vetek Chic On Wheels or its employees, if any, unless arising from
negligence on the part of Vetek Chic On Wheels proven in a court of law.
3. Vetek Chic On Wheels or its employees, if any, shall not be held responsible for the loss, injury, death, or
actions of any pet while in or not in the care of Vetek Chic On Wheels.
4. The client understands that all pets (where appropriate) must have a veterinarian and must be up to date on
the rabies vaccination. It is an Arizona state law that all dogs be current on a rabies vaccine and license.
5. Vetek Chic On Wheels does not work with aggressive animals.
6. Vetek Chic On Wheels does not take dogs on walks unless agreed upon on special circumstances.
7. All animals will need to be transported in a secure, enclosed, crate or pet taxi provided by Vetek Chic On
Wheels or client. If Vetek Chic feels that the clients provided pet enclosure is not secure enough, Vetek Chic
can refuse service or use a secure crate, owned by Vetek Chic On Wheels, with owner consent.
8. All pets must be accompanied by a leash/harness, and/or crate if hired for Taxi.
9. Client is responsible for making all arrangements with veterinarian of choice, prior to taxi appointment. Vetek
Chic On Wheels is not responsible for actions of destination facility. It is a good idea to keep a Credit Card on
File to the nearest Animal Emergency Clinic or your regular Veterinarian while you are away.
10. Vetek Chic On Wheels will not be responsible for any lost keys the client has asked to be mailed.
11. Vetek Chic On Wheels reserves the right to deny service or terminate service because of safety concerns,
financial concerns, or inappropriate or uncomfortable situations.
12. Vetek Chic On Wheels reserves the right to cancel and reschedule service due to sickness or weather concerns.
(This would only be before the start of a Pet Sit job and I would provide back up pet sitters tel. numbers)
13. Business hours fall between the hours of 6:00 a.m. and 7:00 p.m. Monday through Sunday and services are
usually completed during this time unless behind schedule.
14. Payment is expected before services are performed. Vetek Chic On Wheels is not responsible for any fees due
to the Veterinary Clinic, Groomer or Store. Client must make prior payment arrangements. If client would like
Vetek Chic On Wheels to submit payment for client in the form of cash, Vetek Chic On Wheels is not
responsible for any loss.
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My Husband is also covered by my Insurance Policy and I rely on him first before anyone esle. He will perform
a job for me in order to accommodate each Pet Sit if an emergency arises and I am unable to accomodate. If
this is necessary, he or I will inform you as soon as we are able.
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15. Vetek Chic has a Network Circle of Backup Pet Sitters in case of an Emergency. These are trusted professionals.
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
16. No Refunds on Cancellations less than 24 hours. Payment is for the total hired time.
This is due to the fact that I have reserved time for you and have turned other requests away causing loss of
income. VCOW can use discretion for special occasions.
17. 75% Refund is granted if 72 hour or more notice is provided.
18. 100% Refund is granted if 4 days notice or more is provided. You may use this as a credit.
19. Holiday’s are limited and there is an additional $10 daily fee. No refunds if cancelled before 7 days notice.
Please try to schedule 2 weeks prior to the Holiday.
20. Owner understands that Vetek Chic On Wheels offers a support service which provides suggestions learned
through years of professional experience in the veterinary field but that each pet is unique and may react
different to any occasion or treatment and that owner of said animal will release Vetek Chic of any or all
liabilities arising from medical assistance /suggestions/treatments/transportation. Vetek Chic does NOT take
the place of a veterinarian and any immediate medical concerns need to be addressed by your veterinarian.
21. Client agrees to notify VCOW within 24 hours upon return, of any discrepancies or concerns.
22. This agreement is valid from the date signed, and replaces any prior Legal Considerations agreements.
23. The owner states that he/she as read this agreement in its entirety and fully understands and accepts its terms
and conditions.
By signing below the client fully understands and agrees to the contents of this agreement:
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Signed this day:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
KEY AGREEMENT
I,
am assigning a key/s to Vetek Chic On Wheels (VCOW) so that the
said company VCOW may enter my home to perform a scheduled service or to provide transportation for my pet to a
veterinary appointment.

I agree that Vetek Chic On Wheels WILL or WILL NOT
keep a key in their possession in case of
further service requests. By allowing VCOW to keep a key, I am privileged to emergency and short notice
requests as well as eliminating the $10 key pick up fee.
If “WILL” is chosen:
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My keys will be automatically retained by VCOW at the end of each service period .
VCOW will place the key in a secured location until future service is requested.
VCOW has permission to provide my keys to any of its employees or Independent
Contractors that will be providing me with Assistance.
VCOW has my permission to make a copy of my key(s) for emergency / backup purposes at
their discretion. YES or NO
o INITIAL:
It is highly recommended to allow me two copies of your key.
Although extremely aware of the location of your key at all times, accidents and mistakes can
happen. In the event that I am unable to return to your home for reasons beyond my control,
there be an additional key on hand for a back up pet sitter or official to care for your pet/s until
you are notified of my absence.
VCOW agrees to place an identifying code on my keys. My keys will not be marked with your name,
address, or pet’s names. When not in use or prepared for use, my keys will be stored in a secure location.
If “WILL NOT” is chosen:

I am requesting that my key/s be returned on to me on an agreed date/time. I understand there is a $10
charge for VCOW to pick up or return my key and agree to pay for this charge at the Initial Meet and
Greet.
o INITIAL:

I am authorizing VCOW to Mail me my key/s back, regular mail for an additional cost of $5 for
envelope/shipping/handling. I will not hold VCOW responsible for lost keys in the mail.
o

I will not hold Vetek Chic On Wheels liable for any lost or stolen keys.
o INITIAL:
I have received my key back from Vetek Chic On Wheels and determine it is the working key: signed this
date:
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
INITIAL :
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Signed this day:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
VETERINARY RELEASE AGREEMENT (MUST BE FILLED OUT IN CASE OF AN EMERGENCY)
Pet/s and Veterinarian Information
Name of Pet/s:
Name of Veterinarian:
Facility:
During my absence, Vetek Chic On Wheels will be transporting my pet(s). In the event of an emergency, I
authorize you (veterinarian) to administer medical treatment and will be responsible for payment to you
(veterinarian) immediately over the telephone or by the credit card left on file in an amount not to succeed
$
I DO or DO NOT have current Pet Insurance.
I,
, give Vetek Chic On Wheels permission to transport my pet(s)
to the above veterinarian and authorize treatment in the event of an emergency or sickness.
If this veterinarian is not available, I authorize Vetek Chic On Wheels to transport my pet(s) to a veterinarian
of choice and authorize treatment. If emergency care is needed after regular office hours, my pet(s) may be
taken to the nearest Veterinarian Emergency Clinic/Hospital.
I give permission to Vetek Chic On Wheels to approve treatment up to $:
(input maximum dollar amount or “no limit”). I agree to be responsible for all charges upon my return
including, but not limited to, vet fees, extra visit fees and transportation fees. (common charges are $500$1,000 in Emergency Situations)
I agree to authorize the said veterinarian to euthanize my pet in extreme circumstances after all reasonable
attempts have been made to reach me or my emergency contact.
I have a DNR (Do not resuscitate) note attached.
In the event of my pet’s death, I would like the pet:
cremated / kept at vet / other:
I agree that Vetek Chic On Wheels is released from all liability related to transportation to and from
veterinarian and treatment for sickness or emergency.
This release will remain valid for all current and future visits unless a new release is signed.
I DO or DO NOT wish to be notified of my pet’s illness/death before I return home.
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Signed this day:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
PET MODEL RELEASE: simply speaking…. Would you allow me to post pictures of your pet on my
website for yourself and others to enjoy? Revealing personal information, picture’s, or captions, will never
be included. I take every precaution to protect your privacy.
No. ____________ I prefer not to have my pet/s picture on your website.
Yes! ____________ I hereby give permission to: Vetek Chic On Wheels Owner and any
Employees or Independent Contractors:
a) the unrestricted right and permission to post on VCOW’s personal Website, Blog, or Photo Site
as part of promotional use for the business or my personal daily Report Card.
b) I also permit the use of any printed material in connection therewith.
c) I hereby affirm that I am over the age of majority and have the right to contract in my own name.
I have read the above authorization, release and agreement, prior to its execution; I fully
understand the contents thereof. This agreement shall be binding upon me and my heirs, legal
representatives and assigns.
Dated:
Print Name:
Sign Name:
Pet/s:
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1.
2.
3.
4.
5.
6.
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
HIRE DATES
I,
Pet Sitting:
am hiring Vetek Chic On Wheels on the following dates and for the following times for
Beginning date:
Time: (am or pm or Both)
Subsequent Dates:
AM
Ending date:
NOON
PM
Time: (am or pm or Both)
Cost of Services per Visit: $__________________ Total Visits: _________________ Total Cost: $_____________
I understand there is no refund on early home (unless special situations arise that have been
discussed prior) and agree to pay in full at the Meet and Greet or a day agreed upon at the Meet
and Greet visit.
Initial:
I understand that if I choose to cancel that I will give 72 hours or more notice.
If I cancel 24 hours or less I understand there is NO refund. (this is due to the fact that I hold your dates
and turn down further business each day that you have me scheduled) (special circumstances may be approved)
Initial:
I understand that if I do cancel 72 hours or more before the scheduled first visit, I will be paid a
75% refund of requested Services (the 25% fee to me covers any potential lost business requests from other
clients)
Initial:
I understand that if I give a 4 day or more notice of cancellation, I will be refunded 100%.
I understand that there is a $10 per DAY, additional charge on the following Holiday’s and that I
must give at least a 7 day notice of a cancellation for the following Holiday’s:
Christmas Eve and day, Thanksgiving Eve and day, New Years Eve and day, The Fourth of
July day, Labor day, Memorial day, and Easter day.
Initial:
Copyright © 2008 Vetek Chic On Wheels ®
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I understand that if there are Medical Services in addition that there will may be an extra charge for
which I have received an Estimate on costs. These are to be paid in full at the initial Meet and
Greet or agreed day of payment.
Initial:
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I understand that the charge per healthy pet visit is $18 with a minimum of 2 visits daily for the first
2 animals. The additional animal/s may be charged an additional $5 upon my discretion. Once a
day for Cats may be authorized at VCOW’s discretion.
Initial:
Client Packet
Medical Information (Including Diabetic Cats/Insulin Injections)
(PLEASE FILL OUT ONLY IF MEDICAL NEEDS ARE REQUESTED)
Please print one out for each pet if more than one is to be assisted with.
Please provide me with details of your pet’s In-Home requested Medical Treatment Assistance. Leave a copy of
his/her Medical Record if you have them available.
Pet’s Name that requires medication/injections:
What are you requesting Assistance for?
Do you have Prescribed Medication and Instructions for use from a Licensed Veterinarian?
Please provide Medication Names and Instructions:
1.
2.
Can you tell me if there is something your pet/s does NOT like? Ex.: rubbing tummy, holding feet, petting head.
Has your pet (this pet) ever bitten, scratched or attacked anyone before? Even a mild incident must be included.
YES
NO
Can you briefly explain what happened?
If your pet runs away how can he/she be retrieved:
Any special instructions that I should know about?
Please tell me of any commands your pet/s may know, ex.: sit, stay, down, go potty, etc.
Diabetic Cats can sometimes be extremely difficult to work with. If I am unable to administer your cat’s insulin what
would you like me to do? May I provide a Treat or Soft Food in addition to your pet’s regular diet?
I understand that diabetic cats can safely go without insulin for a maximum of 2-3 days. Please ask your vet pertaining
to your pet.
I will not continue to attempt insulin administration to your named above cat if I feel unsafe or at risk of a bite/scratch
or attack. Do you acknowledge that you will not hold me liable if your cat becomes sick because I was not able to
administer Insulin? I may have to admit cat to nearest and available veterinary clinic with boarding. Where would you
like me to take your pet if such should occur?
Yes, I understand the risk and will NOT hold you liable for not administering my cats insulin.
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Signed by Owner of pet:
Copyright © 2008 Vetek Chic On Wheels ®
Client Packet
TAXI AGREEMENT
PLEASE FILL OUT ONLY IF YOU HIRE ME FOR YOUR PERSONAL SHOPPER/OR TAXI YOUR PET TO THE VET
This agreement is effective from:
to:
and is between Vetek Chic On Wheels
and
(herein after referred to as “client”)
Any changes to this agreement must be done so in writing or they will be null and void. Vetek Chic On
Wheels has the right to make any changes to this agreement at will and without notice. With any changes,
a new agreement will be presented before any new services are rendered.
Services/Rates:
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Per One Way Trip: Drop off or Pick Up: Rate: $28 within 5 mile radius. Additional $15 if over miles
Round Trip with Stay Rate: $ 35/Hr
Emergency with Stay: $40-$60/hr depending on time spent and severity.
Name of Destination:
Address:
Facility Phone Number:
Time of Appointment:
Veterinarian’s name:
Does the Veterinary facility know that Vetek Chic On Wheels will be bringing your pet to the above appointment?
Yes
No
Major Crossroads of facility:
Owner has supplied Vetek Chic On Wheels with current Rabies Vaccination record:
yes
no (or the clinic has one on file)
Owner has supplied Vetek Chic On Wheels with current Arizona Pet License:
yes
no
Purpose of Veterinary Appointment:
I,
authorize Vetek Chic On Wheels to transport my pet to the above destination. I agree to be
responsible for full payment of all applicable charges by destination as well as agreed upon trip charges.
PAYPA
CREDIT CARD: (MC,VISA,DISCOVER)
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CASH
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Payment for Services:
Copyright © 2008 Vetek Chic On Wheels ®