Grooming Appointment Form
Schedule Appointment
Your Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pet Details
Pet Name
Species (Dog/Cat)
Breed
Color
Special Markings
Weight
Height
License #
Image of your pet
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Does your pet have any known allergies to food or medicine? If yes, please provide the details below:
Does your pet have any medical condition, physical disability and deformities? If yes, please provide the details below:
Does your pet have completed all vaccinations?
Yes
No
Cats
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Pet size
Small (up to 9 lbs)
Medium (9-13 lbs)
Large (13 lbs and above)
Other
Coat and fur types
Hairless
Sparse-Haired
Curled/Crimped
Shorthair
Semi-long hair
Longhair
Other
Dogs
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Pet size
Extra small (1 lb to 20 lbs)
Small (20-30 lbs)
Medium (30-50 lbs)
Large (50-90 lbs)
Extra Large (90 lbs and up)
Other
Coat and fur types
Smooth coated
Short coated
Medium coated
Long coated
Wire coated
Hairless coated
Other
Owner Details
Pet Owner's Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Services
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Select the service you want
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next
( X )
Bath only
$10.00
$
10.00
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Bath with blow dry
$10.00
$
10.00
Â
Â
Bath with ear cleaning
$10.00
$
10.00
Â
Â
Bath with tooth brushing
$10.00
$
10.00
Â
Â
Bath with nail trim
$10.00
$
10.00
Â
Â
Bath with nail spa
$10.00
$
10.00
Â
Â
All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne)
$10.00
$
10.00
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Combing only
$10.00
$
10.00
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Â
Nail spa only
$10.00
$
10.00
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Â
Nail trim only
$10.00
$
10.00
Â
Â
Pet cologne only
$10.00
$
10.00
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Â
Coat shine only
$10.00
$
10.00
Â
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Mode of payment
Pay cash to clinic
Credit card
Bank transfer
Auto debit
Wire Transfer
Agreement
I confirm that the vaccines of my pet are up-to-date and I'm willing to share documents as proof.
I understand that there's a possibility that may pet might get minor cuts or irritation.
I understand that the clinic will apply necessary medications if there are any signs of fleas.
I release the clinic from any liabilities related to damages, injury, or accidents that might happen during the procedure.
Signature
Date Signed
 -
Month
 -
Day
Year
Date
Submit
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