Grooming Application Form

Providing Only the BEST Pet Care Since 2015!

Welcome to the Brittney's Dog House family! Thank you so much for considering Brittney's Dog House LLC for all your pet care needs. Below you will find the Dog Grooming Consent From which includes a Client Information Form, a Canine Profile Form, Medical Release Form and Dog Care Agreement. The information you will provide on these forms is important and will help us understand the needs of your dog. The forms must be completed in their entirety before your grooming appointment. This includes getting your dog's medical information (shot records and vet contact info), Which you may have your vet email to me at: brittneysdoghouse@yahoo.com. Thank you again for considering Brittney's Dog House, LLC. I look forward to meeting your furry family member and having you join our pack!

Brittney Palmer,

Owner Brittney's Dog House, LLC

Your Name

Address

Cell Phone

Area CodePhone Number

Work Phone

Area CodePhone Number

Email Address

example@example.com

Emergency Contact: Name

Cell Phone

Area CodePhone Number

Your Dogs Name:

Age

Breed

Are they Spayed/Neutered?

Weight

under 20 pounds21-45 pounds46-80 poundsover 80 pounds

Current Hair Length

shortmediumlong

Which Grooming Services are you interested in? (choose one or more options)

How Soon Would You Like to Get Your Dog Groomed?

Veterinary Office Name

Veterinary Phone

Area CodePhone Number

Rabies Expiration Date

Date

Bordetella Expiration Date

Date

DHLPP Expiration Date

Date

Currently on Flea/Tick prevention medication?

Food and Medication Info:

Is your dog currently on any medication? If yes, please describe what for and how to administer:

Does your dog have any allergies (if yes, please explain):

Is your dog allowed to have treats during grooming?

About Your Dog:

Has Your Dog Been Groomed Before? If so, how did they respond to being groomed?

How Well Does Your Dog Tolerate Nail Trimming?

How comfortable is your dog with being handled (touching of paws/mouth, being picked up, etc.)

Does your dog have skin sensitives?

Is your dog friendly with other dogs?

Has your dog ever bitten someone? If yes, please describe:

Does your dog have any known behavioral issues or destructive tenancies?

Is your dog crate trained?

Does your dog know basic commands?

Does your dog have any health concerns that you are aware of?

Does your dog have anything that stands out physically that should be noted: (i.e.: fatty tumors, skin tags, hot spots, skin allergies, etc). If yes, please describe:

Does your dog have any restrictions on his/her activities? If yes, please describe

Is there anything additional that you believe should be known about your dog?

MEDICAL RELEASE FORM

This is a required form for all Brittney’s Dog House, LLC participants receiving services. First andforemost, the safety and wellbeing of your dog(s) is of the highest importance. Ensuring that your pet remains safe and well cared for is our top priority, and as such, we take it very seriously. We do our best to have our pet parents screen for pre-existing health conditions, but some factors may be beyond our control. If, in the event, that a medical emergency arises while a dog is in our care, it is imperative that we are immediately able to get them medical treatment at the closest available facility. We will call ahead to the veterinary offices in closest proximity geographically to us to ensure they can handle the emergency present. Your dog will be rushed to the closest available facility for treatment and you will be notified as soon as any medical problem occures. We notify the owner after we have secured a medical treatment center for the animal to avoid delays that may be caused by emotion on the part of the owner. Our goal is to get your dog medical attention as quickly as humanly possible, for emergencies. For that reason, it is a requirement to have our pet parents sign this form. I, "the pet owner", understand that in the event of a medical emergency that Brittney’sDog House, LLC, at its sole discretion, deems to need the immediate attention of a licensed veterinarian,I authorize Brittney’s Dog House, LLC to seek medical attention at the closest available veterinary facility. I further agree that I am financially responsible for any medical treatment my pet(s) receives as a result of a medical emergency while attending services provided by Brittney’s Dog House, LLC.

Signature of Owner*

Printed Name*

Date*

Date

DOG CARE AGREEMENT

1. I, the dogs owner, further understand that Brittney's Dog House, LLC has relied upon my representation that my dog is in good health and has not injured or shown aggression or threatening behavior to any person in admitting my dog for services at their facility.

2.I, the dogs owner, further understand that the owners, staff, partners and volunteers, will not be liable, financially or otherwise, for injuries to my dog, me or any property of mine while my dog is receiving services provided by Brittney's Dog House, LLC. I hereby release Brittney's Dog House, LLC of any liability of any kind arising from my dog recieving services provided by Brittney's Dog House, LLC.

3. I, the dogs owner, further understand and agree that any problems with my dog, behavioral, medical or otherwise will be treated as deemed best by staff of Brittney's Dog House, LLC, and in what they view as the best interest of the animal. I understand that I assume full financial responsibility and all liability for any and all expenses involved in regard to the behavior and health of my dog.

4. I, the dogs owner, understand by allowing my dog to recieve services offered by Brittney's Dog House, LLC, I hereby agree to allow Brittney's Dog House LLC to take photographs or use images of my pet in print form or otherwise for publication, marketing, and/or promotion.

5. I, the dogs owner, understand that if my dog is found with fleas or ticks, I will be charged an extra fee of
$5.00-10.00 for their removal, shampoo and extra time spent cleaning so there are no active fleas in our
building.

6. I, the dog owner, understand that some processes
during grooming may not be accomplished if my dog shows signs of discomfort or disposition. I will be informed by the groomer if a service was not able to be completed.

7. I, the dog owner, understand that the total cost must be paid upon pick up.

8. I, the dog owner, understand Rabies, Distemper & Parvovirus vaccinations are required, and I must show proof of these when requested. While Brittney's Dog House will do everything in their ability to provide a clean and safe environment for all dogs, I am aware Bordetella,
Parainfluenza, Leptospirosis and Fecal Exams are recommended. If my dog does not have them, I
understand the possible negative effects for my dog.

9. I, the dogs owner, further understand that I am solely responsible, financially or otherwise, for any harm or damage caused by my dog while my dog is recieving services provided by Brittney's Dog House, LLC.

10. I, the dogs owner, understand that if my dog is not picked up within one hour of services completed, I will be charged an additional $15 per hour that my dog is there. If my dog is not picked up by 7pm, boarding fees will be applied to the total cost. I hereby authorize Brittney's Dog House LLC to take whatever action is deemed necessary for the continuing care of my dog. I will pay Brittney's Dog House, LLC the cost of any such continuing care upon demand by Brittney's Dog House LLC. I understand that if I do not pick up my animal, Brittney's Dog House, LLC will proceed according to the guidelines provided by Abandonment Animal Laws. I also acknowledge that I will be fully responsible for all attorneys' fees and associated costs if I abandon my dog.

By signing below I, the dogs owner, agree to the terms and conditions of all listed above.

Signature of Owner*

Printed Name*

Date*

Date

Dog Grooming Consent Form

CLIENT INFO FORM