Grooming PACFA Form

Grooming PACFA FORM

We are licensed through PACFA for grooming. We cannot begin grooming until this form is completed. It is valid for one year starting January and ending in January of the next year and serves as a service contract for the year. We believe in fear free grooming. We don't use kennels unless failure to pick up your pet on time, unless pet arrives kenneled. We try to only have 1 household's animals with us at 1 time. If you have any questions TEXT 970-276-0731 This form will not submit unless all required fields are filled. We use this form for records and emergencies. We reserve the right to end services at anytime. Thank you

Owners Information
Owner's full name:*

First NameLast Name
E-mail Address:
Owner's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*

Area CodePhone Number
Secondary Contact if you can't be reached

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com

Waivers, Disclosures, Terms and Conditions
Waivers, Disclosures, Terms, and Conditions

The Pet Animal Care Facilities Act (PACFA) Program is a licensing and inspection program dedicated to protecting the health and well-being of pet animals in facilities throughout Colorado.
Permissions refer to this visit and all other visits thereafter. Changing your agreement or adding animals requires this form to be filled out again.
Your estimated cost will be the minimum charged for the visit. You may be subjected to additional fees beyond estimated cost; because fees are dependent on the condition, size, and temperment of the animal upon arrival. You agree to pay the invoice amount upon arrival for pick up. No show fees are the price of the visits intentions as we blocked out time in our calendar to hold your spot. After 2 no shows with no communication, we will no longer accept as a client. We are all human please communicate when late, and I will do the same. Occasionally, Sarah's chronic conditions act up and she will reschedule. Please be understanding. We try to be transparent about trasnferrable illnesses and expect the same courtesy from our in home clients so we can protect ourselves.

For animal care sessions beyond 5 miles of the city limits of 80634 Greeley, CO, the Client is responsible to pay mileage for the excess amount (roundtrip). Mileage is to be calculated at the current federal rate of $0.545 per mile and will be clearly presented on Provider’s Invoice to the Client.

All dogs must have proof of Rabies vaccines.
For calmer visit, we allow the use amino acids (L-Theanine & L-Tryptophan), Valerian Root, Melatonin, CBD, or a pet safe calming treat/liquid, sedatives, and/or a blend of calming essential oils & dog pheromones. We are NOT Allowed to provide this or administer without written vet approval. We believe in a fear free visit some dogs or cats may be too fearful to provide services. You would be notified if this happens.

I will Administer at every visitI will Administer only if neededI do not administer anything
In-home Services: Do you agree to have NoCo Animal Care staff members enter your home and provide services. Only with your knowledge.*

AgreeDisagreeNot going to use these services
If in the unlikely event, may NoCo Animal Care Staff preform first aid. If the animal needs urgent medical attention it will be brought to the closest vet unless closed. This is for small cuts. *
This would be for small cuts or other injuries that are not serious enough to need to go to the vet.
19.8.1 Pet animals of different ownership may be housed in the same enclosure, under constant and direct supervision. We don't do this, but PACFA requires an answer*
If deemed necessary, please know we will make decisions that put the animal's care first.
19.8.2 Do you consent to housing boarded dogs in crates.*
This is only if you leave the animal past your allotted time and I have to tend to other clients
19.8.3 Do you give consent to use products not labeled for use on pet animals. We check for pet safety on every product that could be used. This could be as small as saline solution and Vaseline used for anal gland expression.*
We use martingale collars in our grooming room for safe tethering that is fitted to the dog and doesn't have choke option. We don't use other collars including electronic, choke, or prong.
There is a small risk when expressing the anal glands internally that they could rupture. We take serious precautions to prevent this from happening; however if it does we will seek immediate veterinarian care that care will be paid for by the owner upon the vet's timeline. We are not responsible for the rupture(s) or costs. We use Vaseline for this process which is not labeled for pet use but is widely accepted among vets. *
There is a small risk when removing tartar. There is a known link between swallowed tartar that may contain bacteria and raise liver values. We recommend liver support supplements for one week after tartar removal. We take serious precautions to prevent this from happening; however if it does you will seek veterinarian care that care will be paid for by the owner upon the vet's timeline. We are not responsible for the effects or costs. *
In the event there is matting, we will do what's best for the dog in terms of most humane. This includes shaving the areas as low as is needed to remove the matts with the least amount of pain. Matts can cause irritation to the skin underneath and may have caused rashes you weren't able to see before. We will dematt only if it is humane for the dog. We do not dematt cats, they get it shaved off. There is a higher risk of injury when shaving matts off, especially for cats as they have very thin skin. We do our best to prevent this, but occasionally it does happen. If ever there is an occurrence that requires a vet visit, promptly let us know, and we will notify insurance.
Discounts
Veterinarian's Name:*

First NameLast Name
Veterinarian's Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Veterinarian's Phone Number*

Area CodePhone Number
We will seek vet care if deemed necessary and use other vets if the situation warrants it.*

Agree/UnderstandDisagree/Don't Understand *We are sorry, but we cannot provide care if you don't agree.
Comments: Please tell of any allergies or fears here and be sure to remind at visits.
Sign Your Signature using your finger or mouse:

Clear
Enter the message as it's shown*
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

Grooming PACFA FORM

Waivers, Disclosures, Terms, and Conditions

Permissions refer to this visit and all other visits thereafter. Changing your agreement or adding animals requires this form to be filled out again.