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Pet Owners Application
INTRODUCTION
Documents that you Must Supply:
A letter from your Health Professional containing the expected dates of your hospital treatment.
How To Contact You:
We Must be able to contact you and a Friend in an emergency.
How To Contact Your Friend
Names:
We need Your Name so that we know who we are talking to, and who we are welcoming to S.T.A.R.S.
Your Names
Your Friend's Names
We should have a Friend that you trust to make the type of decisions that you want. There may be many times when we will not be able to reach you in hospital, so you will need someone to speak for you.
Your Control
You have Control over when Your Friend Speaks for you. You can change this at any time.
Please indicate to us if the following Declaration of your Current Situation is either True, or False.
I am unable, or will be unable, to provide pet care to my animal companion/s due to my financial, social or illness related circumstances during my hospital stay, and wish to apply for the S.T.A.R.S. service.
🤝 Your Agreement with Furmentality is...
I, The Applicant, am aware that should there be a shortage of foster pet carers my pet will be placed in the Alice Springs Animal Shelter – and all costs will be borne by Me.
I will not hold Furmentality Inc. liable for any injuries my pet causes to the pet foster carer, the members of their household/family or the general public, or any damage to property caused by my pet.
I will not hold Furmentality Inc. liable should my pet /s become lost or injured whilst he/she is in foster care. I understand that all reasonable efforts will be made by Furmentality Inc. and the pet foster carers to find my pet/s and access a vet.
I understand that Furmentality Inc. will not be responsible for any vet bills incurred by my pet and that members of Furmentality Inc. will endeavour to contact me, or My Friend, a person nominated by me, as soon as practicable in case of an emergency.
I agree that I will liaise with Furmentality Inc. regarding any queries and needs of my pet and NOT the pet foster carer.
I agree to take back my pet at the designated time. My pet will be returned to me by a member of Furmentality, not the pet foster carer.
I am aware that, barring unexpected circumstances, should I not take my pet back on the agreed date, my pet may be relinquished to the Alice Springs Animal Shelter, – and all costs will be borne by Me.
Date & Time:
🏥 Your Hospital Stay
Dates, Dates, Dates...
🖼Pet Photos And Updates
Would you like us to take some Photographs for you ?
Choose Your Pets Care Plan
🏨 Your Vet, or Clinic:
We like to use your own Vet, or Clinic, as they know your Pet and keep all of their Records.
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 1
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information we should know?
IF you have
Answered every question for Every Pet.
Then use the
“🎬 Skip Pet Questions 🎬” Button.
Below
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 2
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information we should know?
IF you have
Answered every question for Every Pet.
Then use the
“🎬 Skip Pet Questions 🎬” Button.
Below
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 3
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information we should know?
IF you have
Answered every question for Every Pet.
Then use the
“🎬 Skip Pet Questions 🎬” Button.
Below
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 4
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information we should know?
IF you have
Answered every question for Every Pet.
Then use the
“🎬 Skip Pet Questions 🎬” Button.
Below
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 5
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information we should know?
IF you have
Answered every question for Every Pet.
Then use the
“🎬 Skip Pet Questions 🎬” Button.
Below
Answer every question.
When you have finished all of your Pets then use the
“🎬 Skip Pet Questions 🎬” Button.
NAME PET 6
Health Checks
Health Checks have been included for
Your Pet’s Safety, and the Safety of others.
💊 Pills and Potions
Is your Pet on Regular Medications ?
💉 Vaccination Status
Vaccination Certificate:
Date Next Vaccination Due:
🪱 Worms
Do you give your pet
heart/intestinal worm treatments
monthly, yearly or Not Required ?
🏃🏼✔️ Flea & Tick
Do you use Flea and Tick treatments ?
Identity
It is Critical that accurate information is given here.
🍟 Microchip Number
👶🏻 Pet's Age
😸 Animal Type (i.e. Cat)
🐩 Breed (i.e. Poodle)
⚤ Gender
🛌 Personality and Behaviour
This Section is for the Safety of our Carers, and the General Public.
It is Not here to Pick The Best Animals,
It Is here to Make Sure that our Carer is prepared for your pet.
e.g. If your Parrot Bites, then we will still Care for it lovingly, but Carefully.
🌐 General Personality
Personality: (e.g. timid, quiet, outgoing, gets on with other animals, likes to be the only pet in the home?)
🦖 Other Animals
Describe your pet’s behaviour with other animals – cats/dogs etc
👨👧Children
Describe your pet’s behaviour with children.
💂🏻♀️ Guarding
Does your pet like to guard their food, toys or bed etc?
🌭 Food
What is your pet’s usual food, or diet ?
How often does your pet eat daily ?
🛏 Bedtime
Where does your pet usually sleep?
🦴 Toys
Does your pet have a favourite toy? If so, what is it?
↻ Routines
Does your pet have any special routines? (e.g. treat before bed, toileting before bed etc). Please describe.
🍁 Leaving Alone
Is your pet comfortable with being left alone for short periods of time?
🕺🏼 Exercise
Describe your pet’s usual exercise routine and frequency (e.g. walks, playtime, catch, fetch etc)
🚶🏼♀️Walkies...
Do you want your Pet walked ?
If “No”, then Jump to the Next Question…
We would appreciate any walking instructions that you have, like “🩳 Short Walks Only” or “🐎 Pulls like a Horse” or “🤬 Hates the leash .
Walking Tips, and individual behaviours will also make life 😌 easier for Our Carer.
⚠️⛔️ Risks...
Is your pet prone to bite or scratch?
If Yes, then please explain the circumstances.
📚 Other Information
Is there any other information that we should know ?
Your Comments
Please leave us with Your Comments…
The End !!!!
The Breadcrumb Trail
📬 Healthy_Minds@FurMentality.Life