Crazy Acres Grooming Dog Client Form

Your Name*

First NameLast Name
Dog's information*

Dog'sNameDog's Date of Birth (Approximate)
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Number*
Alternate Number and Name
What is your preferred method of contact?*
Emergency contact name and number
Dog's breed(s) or a description if unknown*
Dog's sex*
Dog's approximate weight*
Veterinarian's name/clinic*
Veterinarian's Number*
Please enter a valid phone number.
How long have you had your dog?*
Is your dog a rescue?*

YesNo
Is your dog house trained?*

YesNo
Is your dog crate trained?*

YesNo
How often do you generally have your dog groomed? *
When was your dog's last professional grooming?*
How often do you brush your dog?*
What you would like done during your pet’s groom? (Bath and deshed, trimming of furnishings, all over haircut, etc)
If your dog is too large to carry, how does he/she do with stairs?
Do you have any objections to us giving your dog treats?*
Does your dog have any food allergies or restrictions? If so, please list:*
Is your dog on any medications or have any medical problems or chronic illnesses that we need to be aware of? Examples: diabetes, seizures, arthritis, etc. Please list and explain: *
Does your dog guard objects or food from people? If yes, please explain.*
Has your dog ever snapped at or bitten a person? If yes, please explain.*
Does your dog have any behavioral problems that we should be aware of? Examples: anxiety, doesn’t like children or other dogs; doesn’t like a specific part of body touched, past traumas, etc.*
Does your dog have any lumps, warts, or growths? Where are they located?*
Is there anything else that you think we should know?
May we use photos we take of your dog on our Facebook page, website, or other advertising purposes?*

YesNo
Who can we thank for referring you to us?
Thank you very much for your time. Crazy Acres Grooming's goal is to provide a fun and safe environment in which to groom your pets.
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Thank you very much for your time. Crazy Acres Grooming's goal is to provide a fun and safe environment in which to groom your pets.