Name

Email

Please provide your email address.

Phone Number

Dog's Name:

Breed:

Age:

Weight:

Medical Conditions/Allergies:

Veterinarian Name and Contact Info (optional):

Services Requested:

Check all that apply.

• Full Groom (Bath, Cut, Nails, Ears)

• Bath Only

• Nail Trim

• De-Shedding

• Ear Cleaning

Preferred Hair Length (for haircuts):

• Short

• Medium

• Long

• As discussed with the groomer

Does your dog have any sensitivities?

(e.g., to water, noise, handling)

If yes, please describe:

Does your dog have any history of aggression or behavioral issues?

If yes, please describe:

Has your dog been treated for fleas or ticks in the past month?

If yes, please describe the treatment:

Is your dog up to date on vaccinations?

If no, please explain:

I understand that grooming can involve the use of scissors, clippers, and other tools which may cause minor cuts or nicks. I agree to release the groomer from any liability due to accidents involving my pet during grooming services.

I confirm that I have disclosed any medical or behavioral issues that may affect my dog’s grooming experience.

I give consent for my dog to be groomed in a safe and professional manner.

If an emergency arises, I authorize the groomer to seek veterinary care at my expense.