Intake Form

1
Business Agreement (PLEASE READ IN ITS ENTIRETY) * This field is required.By agreeing to these terms, you are also agreeing to the “MATTED PET AGREEMENT” and “CANCELLATION POLICY”
2
I understand that services are provided inside the client’s home. Please click YES to continue with the application.* This field is required.
YESNO
3
Pet Parent's Name* This field is required.
First Name
Last Name
4
Pet Parent's Email* This field is required.
example@example.com
5
Pet & Pet Parent's Address* This field is required.As a house call business, I travel to your home. I have a 10 mile radius from the Plano Rd/Magnolia Hills area that is included in the appointment fee. If outside of my service area, each mile after 10 miles is charged $1/mile.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Pet Parent's Phone Number* This field is required.
Please enter a valid phone number.
7
How much does your pet weigh?* This field is required.I WILL NOT be able to accept bath/haircut/nail trim appointments for any pets exceeding 35 lbs.
Numerical characters only
8
Do you smoke in your home?* This field is required.I cannot enter homes that have been smoked in.
YESNO
9
What is your pet's name?* This field is required.
10
What is your pet's age?* This field is required.
11
What breed is your dog?* This field is required.
12
What service are you looking for?* This field is required.Please select from the dropdown menu
Please Select
Please Select
Nails Only
Bath, Brush, & Nails
Bath, Brush, Nails, & Sanitary Trim
Deshedding Bath, Brush, & Nails
Full Groom (Includes Bath, Brush, Nails & Full Haircut)
13
Who is your pet's veterinarian? * This field is required.I require all pets to have a current vet.
14
Is your pet spayed or neutered?* This field is required.
YESNO
15
How long has it been since your dog's last grooming appointment?* This field is required.
16
Is your dog currently matted?* This field is required.Please remember when a dog is excessively matted, the best option is to be shaved and start fresh. Daily brushing and combing prevents matting. I DO NOT offer dematting services and will only provide services that benefit the pet.
YESNO
17
Has your dog ever bit anyone, grooming service or otherwise?* This field is required.
YESNO
18
Does your pet have any health issues?* This field is required.Please include anything you can think of. Being informed is the best way to properly take care of your pet!
19
Does your pet have any specific shampoo requirements?* This field is required.Example: Medicated, hypoallergenic
20
Pet Photo* This field is required.Please upload a recent picture of your pet with the whole body and face in the picture. This can help determine in advance if we can achieve the haircut you're looking for.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
21
Deposit* This field is required.A $25 deposit is required to hold your appointment spot. This applies to the total on the day of the appointment. This can be invoiced by Zelle, Venmo or paid by card. I will send an invoice by your chosen method after your booking is approved.
Zelle
Venmo
Debit/Credit Card
22
How do you prefer to be contacted?
Text message
Phone call
Should be Empty: