New Client Form

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email

example@example.com

Emergency Contact Name

Emergency Contact Number

Please enter a valid phone number.

Secondary Emergency Contact Name

Secondary Emergency Contact Number

Please enter a valid phone number.

Your Veterinarian

Do you authorize Pawsitively Posh Pet Resort & Spa to obtain your pet(s) records?

Do you authorize Pawsitively Posh Pet Resort & Spa to use photos of your pet(s) on social media outlets/website?

How did you hear about us?

Who can we thank for your referral?

Pet #1

Gender

Altered?

Age/DOB

Breed

Color

Medical Conditions/Allergies/Concerns

Pet #2

Gender

Altered?

Age/DOB

Breed

Color

Medical Conditions/Allergies/Concerns

Pet #3

Gender

Altered?

Age/DOB

Breed

Color

Medical Conditions/Allergies/Concerns

Pet #4

Gender

Altered?

Age/DOB

Breed

Color

Medical Conditions/Allergies/Concerns

Permission for Professional Services:
By signing below, I authorize Pawsitively Posh Pet Resort & Spa to provide professional services for my pet(s) as deemed advisable and/or necessary. I agree to pay for the cost of all services to which I consent to by written or verbal estimate, and I understand that failure to pay at the time of discharge will result in additional interest, Collection fees and/or Attorney fees, which I will also be responsible for. I also understand that all returned checks will incur a non-refundable $35 fee.

Signature