Dog Grooming Registration Form

Dog Grooming Registration Form

Owner's Name*

Owner's Address*

Contact Number*

Email address*

Your preferred appointment day and AM or PM*

Pet's Name*

Pet's Sex*

Dog's Breed*

Pet's Date of Birth*

Date

If Male, Neutered?

If Female -

Disabilities, i.e. Deaf etc or state "None"*

Emergency Contact Number*

Vet's FULL Name, Address including Post Code*

Annually Vacinated?*

Treated for Fleas and Worms*

Microchipped?*

Exposed to any dogs with Fleas etc*

Behaviour i.e. Shy, Nervous or state "None"*

Medical History*

Likes / Dislikes or state "None"*

Allergies or state "None"*

Treats Allowed?*

Disclaimer:

I confirm that my pet is fit & healthy & fully vaccinated. I agree that the groomer will not be held liable or responsible for irritation, abrasion, patchiness or hair loss due to any pre-existing skin condition, or a result of grooming, de-matting, thinning, stripping, or shaving, or any mishap caused by my non-disclosure of my pet's medical condition or behaviour.

If my pet bites or attempts to bite any person or pet, a muzzle maybe used, or at the discretion of the groomer, treatment may stop & I will pay for all work done to that point, & I will pay the full cost of all damages & expenses my pet has caused.

I confirm that all the facts I have supplied are true.

If my pet harbours any parasites clear them at my expense.

If my pet's health causes concern, obtain veterinary treatment at my expense.

I agree to pay any charges due to appointments cancelled at short notice.

I accept & consent entirely to all the terms & conditions shown above.

As this is an Electronic Form you should insert your FULL Name in the fields below if you agree with the above Disclaimer and wish to be bound by it.

Your Signature Name*

CLEARLY MARK WARTS, SCARS, LUMPS, SKIN PROBLEMS BELOW

To indicate any of the above you may need to print off this Registration Form, place any markings on the TWO images and bring this Form with you when we provide treatment to your Pet.