Pampered Paws Spa LLC Grooming Appointment Form
715 East Rasback Centralia, IL 62801
Schedule Appointment (1 animal per time slot)
*
Your Name
First Name
Last Name
Groomer Choice
*
Head Groomer/ owner Jamie
Phone Number
Please enter a valid phone number.
Pet Details
Pet Name
Species (Dog/Cat)
Breed
Image of your pet
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Does your pet have any known allergies to food or medicine? If yes, please provide the details below:
Does your pet have any medical condition, physical disability and deformities? If yes, please provide the details below:
Matted Dog Release FormDogs with severely matted coats require extra attention. GROOM! will not cause serious or undue stress to pets by de-matting.Mats can be difficult to remove, and may require the pet to be shaved. Removing a heavily matted coat can cause nicks, cuts, or abrasions. Heavy matting can also trap moisture and urine near the pet’s skin, allowing mold, fungus or bacteria to grow, and or revealing skin irritations that existed prior to the grooming process. After-effects of the mat removal can include itchiness, redness, self-inflicted irritations or abrasions, and failure of hair to regrow. In some cases, pets may also exhibit brief behavioral changes. I hereby release Pampered Paws Spa LLC from any liability associated with any and all injuries or medical problems that may be uncovered and or occur during the stripping and de-matting process. Should my pet need veterinarian care after or during the process of de-matting, I agree to pay any and all veterinarian fees. Please include Dog’s name, owner’s name, and today’s date in box below to agree to the above.
*
Does your pet have completed all vaccinations?
Yes
No
Cats
Pet size
Small (up to 9 lbs)
Medium (9-13 lbs)
Large (13 lbs and above)
Other
Coat and fur types
Hairless
Sparse-Haired
Curled/Crimped
Shorthair
Semi-long hair
Longhair
Other
Dogs
Pet size
Extra small (1 lb to 20 lbs)
Small (20-30 lbs)
Medium (30-50 lbs)
Large (50-90 lbs)
Extra Large (90 lbs and up)
Other
Coat and fur types
Smooth coated
Short coated
Medium coated
Long coated
Wire coated
Hairless coated
Other
Owner Details
Pet Owner's Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Services Please note these are the base price! Total may be more.
Select the service you want
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Standard Poodle/ Poodle mix All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne) price listed is base price price may be more depending on condition of coat.
$
90.00
Small Dog All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne)
$
55.00
Medium Dog All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne) 2
$
65.00
Extra Large Dog All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne) 4
$
85.00
Large Dog All-in-one (bath with blow dry, ear cleaning, tooth brushing, nail trim, and spa, coat shine, combing, and cologne) 5
$
75.00
small dog Bath only
No haircut Bath ONLY
$
45.00
medium dog Bath only
No haircut Bath ONLY
$
55.00
Large dog Bath only
No haircut Bath ONLY
$
65.00
Extra large dog Bath only
No haircut Bath ONLY
$
75.00
tooth brushing
$
5.00
nail trim
$
12.00
Nail trim with Dremel
$
24.00
Quantity
1
2
3
4
5
6
7
8
9
10
De-Matting
$10 per hour Add On
$
10.00
Method of payment
Debit/Credit card
Cash App
Venmo
Check
Cash
Agreement
Please read ALL once you hit submit you are agreeing to all policies and procedures at Pampered Paws Spa LLC.
I confirm that the vaccines of my pet are up-to-date and I'm willing to share documents as proof.
I understand that there's a possibility that may pet might get minor cuts or irritation.
I understand that Pampered Paws Spa LLC will apply necessary medications if there are any signs of fleas.
I release Pampered Paws Spa LLC from any liabilities related to damages, injury, or accidents that might happen during the procedure.
If you are unable to be at your scheduled grooming appointment, we ask that you please cancel or reschedule a minimum of 24 hours in advance, in order to allow an appointment for another pet that is waiting. Any appointments not canceled or rescheduled prior to this time frame will incur a $25 fee per pet. Last minute cancellations or no shows not only seriously disrupt our schedule, but force others to wait longer than necessary for appointments there for when this happens, so you will be sent an invoice for 1/2 of your total grooming bill for the no shows/ last minute cancellations to be able to rebook your pets. We understand occasionally things do come up, but really appreciate the courtesy of a timely notice.
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