Your Name
*
First Name
Last Name
Dog's information
*
Dog'sName
Dog's Date of Birth (Approximate)
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
Format: 000-000-0000.
Alternate Number and Name
Format: 000-000-0000.
What is your preferred method of contact?
*
Emergency contact name and number
Dog's breed(s) or a description if unknown
*
Dog's sex
*
Please Select
Intact male
Neutered male
Intact female
Spayed female
Dog's approximate weight
*
Veterinarian's name/clinic
*
Veterinarian's Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How long have you had your dog?
*
Is your dog a rescue?
*
Yes
No
Is your dog house trained?
*
Yes
No
Is your dog crate trained?
*
Yes
No
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?
*
Yes
No
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.
Submit
Should be Empty: