2021 New Client Release Form

How did you hear about us?

Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home

Please enter a valid phone number.

Cell 1*

Please enter a valid phone number.

Cell 2

Please enter a valid phone number.

Work

Please enter a valid phone number.

Pets Name*

Dog or Cat*

DogCat

Breed of Pet*

Pet's Weight*

Male or Female*

MaleFemale

Spayed / Neutered*

YesNo

Pets Age*

Pet's Name (Pet #2)*

If you do not have more than one pet, please type N/A

Breed of Pet (Pet #2)

Dog or Cat (Pet #2)

DogCat

Breed of Pet (Pet #2)

Pet's Weight (Pet #2)

Male or Female (Pet #2)

MaleFemale

Spayed / Neutered (Pet #2)

YesNo

Pets Age (Pet #2)

Please Initial - PACFA (Colorado Department of Agriculture Pet Care Program) has recently updated its vaccine requirements for the pet care industry. Their guidelines now recommend that all animals be vaccinated for rabies (starting at 16 weeks), as well as distemper, parvovirus, and FVRCP (for cats) starting at 8 weeks of age. However, the State of Colorado has not changed its legal vaccine requirements. A Clip Above will continue to follow state law, which only requires proof of a current rabies vaccination.I certify that I have read and understood the information provided on the Vaccination Acknowledgement & Exemption Form below and choose to provide only the legally required rabies vaccine records. I also acknowledge that A Clip Above still requires proof of rabies vaccination.*

After reviewing the Vaccination Acknowledgement & Exemption Form, please select one of the following options:*

My pet(s) is medically exempt from one or more of the recommended vaccinations. I agree to provide a signed exemption letter from a licensed veterinarian, stating the medical reason for exemption.I have chosen not to vaccinate my pet(s) beyond the rabies vaccine. I understand and accept the risks associated with this decision.My pet(s) is fully vaccinated and I will upload the vaccination form.

My dog(s) is unable to get some or any vaccines due to health issues per our veterinarian. I understand the risks of my dog(s) not being fully vaccinated. Please type N/A if this does not apply to you. *

Is your pet(s) current on rabies shot?*

YesNoOther

Is your pet(s) exempt from getting vaccines due to health reasons? If yes, please upload the Vaccine Exempt form from your vet below.*

YesNo

Vaccine Record/ Vaccine Waiver*

Vaccine Record/ Vaccine Waiver (Pet #2)

Current Veterinarian Name*

Vet Phone Number

Please enter a valid phone number.

Health Conditions

Health Conditions - Other

Pet's Behavior

FearfulnessSensitivityAggressive with peopleAggressive with Animals

Although grooming accidents are rare, there is always a risk when working on a pet. If an accident occurs you will immediately be notified of the incident via the contact number(s) you list at the top of this form. Grooming equipment is sharp, even though we use extreme caution and care in all situations, possible problems could occur including: nicks, cuts, scratches, quicking of the nails, etc. In the best interest of your pet, we request your permission to obtain immediate veterinary care if it becomes necessary. Any veterinary bills resulting from a pet being matted, senior or from a pre-existing or unforeseeable condition will be the responsibility of the pet owner. In many cases this can happen when a pet is over excited, wiggling or moving around . We ask if you happen to arrive before your pet is finished please do not get them too excited while they are on the grooming table, we ask this only for the safety of your pet.

Please Initial - Overall Health and Behavior of Pet: I understand and agree that A Clip Above is relying on my confirmation that my pet is in good health, has not exhibited aggressive or threatening behavior toward people or other animals, is up to date on all required vaccinations, is free of parasites, and has no open wounds or existing injuries. *

Please Initial - Aggressive Pets: A Clip Above reserves the right to refuse service or discontinue grooming at any time if a pet becomes overly stressed or poses a risk to itself, other animals, or staff. Our priority is your pet’s well-being, and we will only proceed with grooming tasks that your pet can tolerate comfortably and safely.*

Please Initial - Parasites: A Clip Above reserves the right to refuse service or stop a grooming session immediately if any parasites—such as fleas, ticks, lice, or bot flies—are found on your pet. To protect all pets in our care, your pet will be placed in a clean, comfortable isolation kennel, away from others, to prevent the spread of parasites. Unfortunately, your pet will need to be sent home, even if the groom is not completed.If your pet is already in the tub at the time of discovery, we will complete the bath (including nail trimming and ear cleaning) and charge for a Bath & Brush service. In this case, we will apply a 20% discount to reflect the incomplete grooming due to necessary safety precautions.*

Please Initial - Owner Responsibility: The owner agrees to be responsible and liable for the behavior of their pet. This may include, but is not limited to, injury of staff member, injury to pet, or injury to another pet(s).*

Please Initial - Grooming Enclosures: I agree and understand that my dog(s)may be placed in grooming enclosures before, during or after grooming.*

Please Initial - Risks to Pet: While every effort is made to groom your pet safely and gently, the owner understands that grooming may occasionally result in minor issues such as stress, skin irritation, small nicks, or nails trimmed too short. Less common reactions may include bleeding from minor cuts, clipper irritation, or physical/mental stress after grooming. Grooming can also reveal or worsen existing medical conditions. The owner agrees not to hold A Clip Above liable for any injuries or health issues that may occur during or after grooming. *

Please Initial - Aging and Special Needs Pets: The owner understands that grooming can be physically and emotionally stressful for aging or medically fragile pets. This stress may trigger existing or hidden conditions (e.g., joint pain, surgical site issues, or organ problems), potentially leading to illness, seizures, or even death. While A Clip Above will handle all pets with care, the owner agrees not to hold A Clip Above liable for any medical issues that may arise during or after grooming.*

Please Initial - Moles/Skin Lesions/Tumors/Other Skin Irregularities: Skin growths or irregularities that protrude may be accidentally nicked or irritated during grooming. The owner accepts this risk and agrees not to hold A Clip Above responsible for any resulting cuts, nicks, or skin reactions.*

Please Initial - Cancellation & No Show Policy: Cancellations made the day before the scheduled appointment will incur a 50% charge, and cancellations or no-shows on the day of will be charged 75% of the estimated grooming fee. By booking an appointment, you agree that these fees will be charged to the card on file or must be paid before future bookings. Failure to pay will result in a suspension of booking privileges until the balance is cleared.*

Please Initial - I understand that upon scheduling my first appointment I have to provide credit card information. I understand that my card will be kept on file with Square, to be used as a form of payment when I reschedule, cancel, or no-show my booked appointment within the cancellation policy window. I also understand that if I choose to not leave my dog(s) for their appointment I will be charged as if it was a no call no show. If my card is to be charged I understand I will be notified of the reason for the fee and the amount charged. *

Please Initial - Administering Aid: I understand and agree that if my pet becomes ill or appears to need medical attention while in the care of A Clip Above, they have full discretion to seek and authorize necessary treatment. I agree to cover all related expenses, including veterinary care, medications, exams, or surgery. A Clip Above will make reasonable efforts to contact me first, but if I am unreachable or immediate action is needed, they may proceed with treatment without prior notice.*

Please Initial - Release of Liability: I understand and agree to release A Clip Above—including its owners, staff, partners, and volunteers—from any financial or legal responsibility for injuries to my pet, myself, or my property that may occur while my pet is receiving services from A Clip Above.*

Please Initial - Social Media: A Clip Above does take pictures/videos of my pet before, during, and after the groom. These photos are used to celebrate my pet's grooming as well as the groomer's skill set. I agree to allow A Clip Above to post these on social media. *

Please Initial - At A Clip Above we strive for the upmost perfection of every dog and cat groom that leaves the facility. I understand that I can call within 48 hours to have any issues with my groom fixed and/or noted for the next time I come in. *

Vaccination Acknowledgment & Exemption Policy

In compliance with current PACFA (Pet Animal Care and Facilities Act) regulations, A Clip Above - Pet Styling is required to maintain documentation of core vaccinations for all dogs receiving grooming or daycare services. While the State of Colorado only mandates rabies vaccination, PACFA recommends additional vaccinations to help protect the health of all pets in our care.

The recommended core vaccinations include:

- Rabies (required by law)

- Distemper

- Parvovirus

- Bordetella (kennel cough)

We understand that some dogs may be exempt from certain vaccinations for medical reasons, and we respect that some clients may choose to limit vaccinations beyond the legal requirement. To ensure transparency and safety, we require the following acknowledgment.

Health & Safety Acknowledgments:

- My pet is not currently showing signs of illness, including (but not limited to) kennel cough, vomiting,diarrhea, or any other contagious condition.

- I understand that other pets at A Clip Above - Pet Styling may not be fully vaccinated, and while every effort is made to maintain a safe and sanitary environment, the risk of exposure to communicable diseases (such as kennel cough, distemper, or parvovirus) cannot be completely eliminated.

- I accept full responsibility for my pet's health status and vaccination choices.

Veterinary exemption documentation (if applicable) must be submitted with this form.

Thank you for working with us to provide a safe and respectful environment for all of our clients and their pets

By signing below, I confirm and agree that I have read and understood the Vaccination Acknowledgement & Exemption Form:*

By signing below you acknowledge that you have read, understand and are in agreement with the above statements, policies and procedures.

Clients Name (Printed)*

Clients Signature*

Date