Contact Information

Cozy Comforts Pets & More – Contact Information

First Name:                Last Name:
Pet(s):                Inquiry Date:          /      /            Method:
                Returned Call:
                Home Phone:
                 Cell Phone:
Address:                Work Phone:
                Email:
Directions:                Prior Sitter:
                 Referred By:
                Contact Method:   □ Home Phone    □ Cell      □ Email
   Date   Time           Status:   □ Will Call Back
□ Interviewing Others Also
Consultation:                  Service Type:   □ Vacation     □ Periodic     □ Daily
First Sit:                   Frequency:       X per    □ Day      □ Week
Start                       Length:    ________ Minutes Per Visit
          End                 Rates Quoted:
Second Sit:
Start                Travel:    $____   Miles: ______     Mins:______
End

Scheduling:   □ Tentative      □ Reserved
References:


Emergency Contacts           (Alternate)           Special Alerts
Name:                   □ FLIGHT RISK, Describe:
Phone:                   □ OUT ON LEASH ONLY            □ No Leash Outside
Cell/Work:                   □ WATCH DURING FEEDINGS   □ Separate Dishes
Relationship:                   □ NO TREATS    □ Pick Up Dish after ______ Mins
Location:                   □ Other: