Client Questionnaire

New Client Application

The Canine Coiffure LLC
Thank you for your interest and for taking the time to fill out this application. Submission does not guarantee an appointment. Completing this form will place your dog on my waitlist.
Your name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Your dog(s) name(s)*

First Dog Second Dog
Your dog’s breed*
Your dog’s age and weight*
I am only accepting clients who are committing to a 4 week appointment schedule and whose dog weighs less than 20lbs at their adult weight. A non-refundable deposit will be required to hold appointments (exception for nail trim clients). Is this commitment understood?*

Yes, I understand I will be required to keep a 4 week appointment schedule.Yes, dog(s) weigh less than 20lbs.I agree to pay a non-refundable deposit to hold my dog’s appointment.
Which of our services are you interested in?*

Nail trim appointmentFull service bathFull service grooming/styling
How did you hear about me?*

ReferralGoogle SearchSocial mediaVeterinarianOther
Please upload a current photo of your dog(s).*

Please include any attachments (e.g., logo, mission statement, annual report, etc.) that would help us better understand your company's needs.
Cancelof
Does your dog(s) have any health or behavioral problems?*
Please describe the type of haircut/style you are interested in. *
Why do you feel the one-on-one grooming experience is best for your dog?*
Please tell me about your past professional grooming experience and/or why you are seeking a new stylist.*
What days/times are best for you to schedule an appointment. Appointments are scheduled Monday-Friday, 8am-2pm.*
Please note that my hourly rate starts at $100 per hour for dogs under 20lbs. Dogs over 20lbs start at $125 per hour.

My services are all-inclusive and are priced based on the hourly system. For more information please visit my website.

All new bookings will be required to keep a credit card on file. No exceptions.
By signing below you are stating that you understand that all of the above information is true, and that by submitting this form does not guarantee an appointment with The Canine Coiffure. I will be in touch through text message if I am going to schedule your dog.*

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New Client Application