Client Intake Form
Name
*
First Name
Last Name
Email
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Veterinary Clinic
*
Dogs Name
*
Breed
*
Age
*
Weight?
*
Is your dog spayed/neutered?
*
Yes
No
Is your dog up to date with vaccinations?
*
Yes
No
Has your dog ever been professionally groomed before?
*
When was the last time your dog was groomed professionally?
*
How does your dog behave for nail trims?
*
Does your dog have any behavioural concerns? (Such as high anxiety, fear aggression, bite history with grooming)
*
Has a groomer ever given you any negative feedback about your dog? If so please explain
*
Is your dog good around other dogs?
*
Why are you leaving your current groomer?
*
Does your dog have any medical concerns or allergies? If so please explain
*
How did you hear about us? If it was a current client who?
*
Please upload a current photo of your dog
*
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