Please enable JavaScript in your browser to complete this form.Origin InformationShippers/Owners Name *FirstLastShippers/Owners Pick up location *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeShippers/Owners Phone *Shippers/Owners Email *Pet(s) being transported *Date of Pick-up *Destination InformationDelivery Name/Location *Delivery Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDelivery Phone *Arrival TimeOur time of arrival is approximated. Should a delivery be delayed due to inclement weather or traffic, you will be notified in a timely manner. If no one is available to receive the animal at the other end of the transport and we are unable to contact the responsible party, there will be a $100.00 per day charge per animal to offset the cost of providing care. The shipper/owner will be responsible for the charge. It is recommended that alternate arrangements be in place in case the person responsible for receiving the animal is unable to do so.InsuranceAlthough we take the utmost precautions to provide the safest care possible in transporting your pets, accidents remain a possibility in certain circumstances beyond our control. While our drivers/attendants are very well trained, the following applies to each individual carrier we transport. Our Standard Insurance: Each shipping carrier we transport is insured up to $100.00 at no additional charge to you. Additional Insurance: To protect you further against any loss that may occur in the event of an unfortunate accident, we recommend that you ensure containment with our additional insurance. Price – Insured container value $50.00 - $500.00 $100.00 - $1,000.00 $200.00 - $2,000.00 Conditions: All insurance coverage is for animals lost, stolen or killed while being transported in our care. The insurance does not compensate for animals that become ill or die during or after a normal transport, nor does our insurance coverage include losses incurred by Acts of God.Do you wish to purchase additional insurance at this time? *YESNOAdditional Insurance Choices?$50.00$100.00$200.00The shipper/owner will be notified immediately should the animal become ill during transport. And veterinary assistance will be provided. The shipper/owner will be responsible for the cost of the veterinary services.Date *Customer Signature *Service Contract *I accept the terms and conditions of the Service Contract belowOur time of arrival is approximated. Should a delivery be delayed due to inclement weather or traffic, you will be notified in a timely manner. If no one is available to receive the animal at the other end of the transport and we are unable to contact the responsible party, there will be a $100.00 per day charge per animal to offset the cost of providing care. The shipper/owner will be responsible for the charge. It is recommended that alternate arrangements be in place in case the person responsible for receiving the animal is unable to do so. Insurance Although we take the utmost precautions to provide the safest care possible in transporting your pets, accidents remain a possibility in certain circumstances beyond our control. While our drivers/attendants are very well trained, the following applies to each individual carrier we transport. Our Standard Insurance: Each shipping carrier we transport is insured up to $100.00 at no additional charge to you. Additional Insurance: To protect you further against any loss that may occur in the event of an unfortunate accident, we recommend that you ensure containment with our additional insurance. Price – Insured container value $50.00 - $500.00 $100.00 - $1,000.00 $200.00 - $2,000.00 Conditions: All insurance coverage is for animals lost, stolen or killed while being transported in our care. The insurance does not compensate for animals that become ill or die during or after a normal transport, nor does our insurance coverage include losses incurred by Acts of God. The shipper/owner will be notified immediately should the animal become ill during transport. And veterinary assistance will be provided. The shipper/owner will be responsible for the cost of the veterinary services. I understand that submitting this form makes it a legal and binding document.Submit