Grooming Admission Form

Grooming Admission Form

Form needs to be completed every 6 months per pet
Name:*

First NameLast Name
Best Contact Number:*
Please enter a valid phone number.
Secondary Contact Number:
Please enter a valid phone number.
Email:*
example@example.com
Pet's Name:*
My pet is a*

DogCat
All dogs entering the hospital must be up to date on the folowing required vaccines:

Rabies, DA2PP and Bordetella

All pets must be free of external parasites otherwise they will be examined, treated, and/or vaccinated at the owners' expense. Exceptions will only be made for medical reasons and be dealt with on a case-by-case basis. Decisions will be made Elkridge Animal Hospital management.
All cats entering the hospital must be up to date on the folowing required vaccines:

Rabies and FVRCP

All pets must be free of external parasites otherwise they will be examined, treated, and/or vaccinated at the owners' expense. Exceptions will only be made for medical reasons and be dealt with on a case-by-case basis. Decisions will be made Elkridge Animal Hospital management.
I would like to authorize someone else to pick up my pet if I am unable:*

YesNo
Authorized person:

First NameLast Name
I would like to authorize an emergency contact if I am unable to be reached in an emergency:*

Yes. This person is authorized to make immediate emergency decisions and I understand I will be completely responsible for any associated costs at time of discharge.No
Emergency Contact:*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.

1. I have informed the groomer of any potential medical or behavioral issues my pet experiences including, but not limited to, cardiac conditions, arthritis, seizures, aggression, or anxiety.

2. I understand that the greatest care will be taken with my pet; however, even with all precautions taken problems do arise on occasion, such as nicks, clipper irritation, and/or stress. In case of any accidents or emergencies, Elkridge Animal Hospital will contact you at the earliest ability.
I authorize Elkridge Animal Hospital to administer appropriate care, if necessary, and I assume full financial responsibility. All payments are due at time of discharge.

3. Matting or severely tangled hair can increase the risk of injury and will incur additional charges due to the extra time and care needed. Sometimes, matting can hide skin infections or irritations that are only seen once the matting is removed. Elkridge Animal Hospital will notify you if any medical concerns.
Please ask the groomer at drop off regarding any additional costs if your pet is matted.

4. Aggressive pets may be charged a special handling fee of $25.00.

5. Aggressive, senior, or disabled pets may not be able to be finished in one session and may be asked to return on another day and time to complete the grooming. Oral medication to help alleviate stress and/ or to reduce hyperactivity may be required. Medications dispensed by Elkridge Animal Hospital require a recent exam by an Elkridge Animal Hospital veterinarian.

6. I understand that Elkridge Animal Hospital is not responsible for any lost items e.g. leashes, collars.

7. I understand that repetitive last-minute cancelations may result in a non-refundable deposit being required to schedule future grooming appointments.

8. I understand that payment for all services rendered is required at time of discharge.

9. This consent form is valid for today and future grooming services for the next six (6) months.

I have read and agree to the above listed terms and conditions.
Signature:*

Clear
Date*

MonthDayYear
Date
Should be Empty: