Grooming Form

Name

First Name Last Name

Email

example@example.com

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Primary Phone Number

Area Code Phone Number

Secondary Phone Number

Area Code Phone Number

Emergency Contact

First Name Last Name

Emergency Contact Phone

Area Code Phone Number

Dog Name

Breed

Color(s)

Birthday/Age

Male or Female

Spayed or Neutered

Yes No

Primary Animal Hospital

Has your dog ever been groomed?

How did they behave?

How does your dog behave for pedicures?

Are there any sensitive areas on your dogs body?

Is your dog used to a high velocity dryer?

Is your dog crate trained/comfortable in a crate for short periods?

Is your dog good with other dogs?

Does your dog have a history of skin infections, seasonal allergies, joint issues, or any other medical conditions we should be aware of?

Current Vaccinations/Veterinarian Information: By signing this contract, owners verify their pets are current on Rabies. Distemper & Bordatella vaccinations are strongly recommended. Proof of vaccination must be submitted prior to grooming.

Temperament: The Wiggle Room does not groom aggressive dogs. If your dog has shown any signs of aggression while being groomed, please notify the staff. If your dog shows any signs of aggression while in the care of The Wiggle Room, we reserve the right to use a muzzle for the safety of your dog and our employees and/or stop a grooming procedure at any time.

Health: Grooming procedures can sometimes be stressful, especially for a senior pet or pet with health problems and can expose hidden medical problems or aggravate a current one during or after the groom. In the best interest of your pet this contract will give The Wiggle Room permission to obtain immediate veterinary treatment for your pet should it be deemed necessary. It is agreed that all expenses for veterinary care will be covered by the pet's owner upon signing this contract/agreement.

Fleas/Ticks/Skunks: The Wiggle Room strives to be a flea and tick free salon. We do not offer chemical flea dips or sprays. If your pet has a heavy flea infestation, we will ask that you reschedule your grooming appointment once the flea problem is under control. Please keep your dog current on parasite prevention to control internal and external parasites. The Wiggle Room does not offer de-skunking treatments.

Accidents: There is always the possibility an accident could occur. Grooming equipment is sharp, even though we use extreme caution and care in all situations, possible problems could occur including cuts, nicks, scratches, quicking of nails, etc. In most cases this can happen when a pet is wiggling or moving around.

De-Matting & Shaving: If your pet cannot be humanely dematted, we will ask permission before starting to shave the coat. Please keep in mind that a matted coat can cause numerous health conditions including itching, irritation, and skin infections. Removing a heavily matted coat includes risks of nicks, bruising, cuts or abrasions due to warts, molds and skin folds trapped and hidden in the mats. Heavy matting can also trap moisture near the pet’s skin allowing fungus or bacteria to grow causing skin irritations that exist prior to the grooming process. The Wiggle Room is not responsible for any pre-existing conditions due to a matted coat. Extra charges apply.

Hold Harmless Agreement: By signing this contract, you (or your Agent) agree to hold The Wiggle Room, it's owner, employees, officers and directors harmless from any damage, loss, or claim arising from any condition of the undersigned pet, either known or unknown to The Wiggle Room. It is also further understood and agreed the terms of this agreement can change at any time, without notice, and will overwrite any and all prior signed contracts or releases.

Date

Signature *

Clear

You may upload an image of your dogs vaccine information here or email separately

Grooming Form

Owner Information

Dog Profile