Companion Grooming Form

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Grooming Form

Please fill out this form when you have scheduled a grooming appointment, so that we can keep your pet beautiful.

If you have any questions, please call us at (703) 250-4100.
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Owner Name* This field is required.
First Name
Last Name
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Owner Email* This field is required.
example@example.com
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Owner Phone Number* This field is required.
Phone Number
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Date of your Appointment* This field is required.
Date
Month
Day
Year
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Pet Information* This field is required.
Pet Name
Breed
Weight
Pet Age
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Would you like us to call when done?* This field is required.
YESNO
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Medical Information* This field is required.
Does your pet have any medical problems?
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Grooming Information* This field is required.
Type of grooming:
Length of hair to be left on pet:
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Additional Shampoo and Grooming Options* This field is required.*There may be additional charges for these options
Conditioner
Medicated Shampoo
Oatmeal Shampoo
Whitening Shampoo
Blowout
Brush Out Undercut
Demat
None
Tooth Brushing
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Agreement

If your specified groom must be altered due to heavy matting, an attempt to contact you will be made. If we are unable to reach you the groomer will continue with the service at an additional charge. If sedation is necessary, we will attempt to contact you.

I understand that if fleas or ticks are found on my pet that Companion Animal Clinic will administer treatment. I agree to pay for services required for treatment. I understand that the bordetella vaccine is required to proceed with any grooming services and I authorize the staff to administer the vaccine if it is due.
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Signature* This field is required. By signing this you agree to the terms on the previous page. Thank you.
Should be Empty: