Registration form – SuPaw Nanny

Registration Form *

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Landline Telephone Number *

Mobile Telephone Number *

Email *

Address *

Facebook Account Name

Twitter Account Name

Name of Emergency Contact *

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We will require an Emergency Contact whilst your pet is in our care.

Landline Telephone Number of Emergency Contact

Mobile Telephone Number of Emergency Contact

Email of Emergency Contact *

Address of Emergency Contact *

Name of Pet(s) *

If more than one, add each pet name here.

Species of Pet(s) *

Breed of Pet(s) *

Sex of Pet(s) *

Coloring of Pet(s) *

Enter pet coloring and any unique marking(s).

Fixing of Pet(s) *

Please enter whether your pet(s) is entirespayedneutered.

Age/Date of Birth of Pet(s) *

Identification of Pet(s) *

Please insert Chip ID number, Collar tag, Tattoo and/or other as applicable.

Special Requirements in relation to your Pet(s) *

Please enter any special requirements/allergies that your pets carer should be aware of ie: Allergic to diary etc.

Vaccination Renewal *

Please state the renewal date of your pet(s) vaccination. An up-to-date veterinary vaccination record must be seen prior to boarding dogs specifically to ensure they have current vaccinations against Parvovirus, Distemper, Hepatitis, Leptospirosis and Kennel Cough. Certification from a veterinarian of a recent protective titre test may be accepted instead of a booster vaccination. The certificate must state that it is valid for the current period of boarding. Primary vaccination courses must be completed at least two weeks before visiting SuPaw Nanny.

Registered Veterinarian *

Please confirm name, address and contact details of your pet(s) Registered Veterinarian.

Medicinal Permissions *

In the event of a clinical/medical emergency where I am unavailable or cannot be reached, I give full consent to SuPaw Nanny to make decisions regarding my pet(s) health provided it is at all-times acting in the best interests of my pet and on the advice of a veterinary surgeon. And as owner, I am responsible for payment of any veterinary fees incurred by this and will be required to refund SuPaw Nanny any expenses from seeking medical attention within seven days. Including transportation (mileage will be charged at 0.50p/mile).

I authorise SuPaw Nanny to utilise her own Registered Veterinarian in the event that my pets regular veterinarian is unavailable. As such, I agree to reimburse SuPaw Nanny for any additional fees for providing emergency care, as well as any expenses incurred for unexpected visits, transportation (to include mileage which is charged at 0.50p/mile) within seven days.

Insurance Details of Pet(s) *

Please enter name of your pet insurer, including policy number and a contact telephone number.

Temperament of Pet(s) *

In regards to general disposition, please confirm your pets nature.

Temperament of Pet(s) in relation to other Animals *

In regards to socialization, please confirm your pets temperament when mixed with its own species and that of others.

Temperament of Pet(s) in relation to Children *

In regards to socialization, please confirm your pets temperament when in company of children.

Temperament of Pet(s) in relation to Strangers *

In regards to socialization, please confirm your pets temperament when in company of strangers.

T&C Permission *

I have understood and agree to all of the above in conjunction with SuPaw Nanny's full Terms and Conditions of Business.

SuPaw Nanny's full Terms and Conditions of Business can be found online at www.supawnanny.co.uk

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