In-Home Pet Grooming Consent & Service Form

1
Owner Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.Number that can receive text messages
Please enter a valid phone number.
3
Email* This field is required.
example@example.com
4
Secondary Contact Information* This field is required.Incase of emergency and we can’t reach you, please list the information below.
Name
Please enter your phone
5
Service Address* This field is required.The address we will be traveling to for the grooming
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
Animal Information* This field is required.Please give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed and or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
7
Animal InformationPlease give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
8
Animal InformationPlease give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
9
Animal InformationPlease give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
10
Animal InformationPlease give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
11
Animal InformationPlease give information on your pets that we will be grooming. 6 pages for up to 6 pets, you can reach out if you have more. Otherwise skip page.
Pets Name
Breed or species if not a dog
Weight
Behavioral Issue/Medical Notes/Etc
12
Grooming Consent* This field is required.I authorize Tughill Pet Grooming LLC to perform grooming services for my pet inside my home. Services may include bathing, drying, brushing, clipping, nail trimming, ear cleaning, and other requested grooming services.I understand grooming tools include sharp equipment and moving parts. While every precaution will be taken, there is always a small risk of accidental injury when working with animals.
Please initial to acknowledge
13
Aggressive Pet / Safety Restraint Permission* This field is required. I understand that grooming can be stressful for some pets and behavior can be unpredictable. If my pet shows signs of aggression or poses a safety risk, I give permission for Tughill Pet Grooming LLC to use humane safety restraints including muzzles, grooming loops, or other safety equipment necessary to safely complete the grooming service. If my pet becomes too aggressive or stressed to safely continue grooming, I understand the service may be stopped and I will still be responsible for the grooming fee.
Please initial to acknowledge
14
Matted Coat Policy* This field is required.If my pet’s coat is severely matted, I understand shaving may be necessary for the health and comfort of my pet.I acknowledge that removing severe matting may reveal pre-existing skin conditions and may cause temporary irritation, redness, swelling,or minor nicks due to the condition of the coat. I give permission for Tughill Pet Grooming LLC to shave my pet if necessary for humane and safe grooming.
Please initial to acknowledge
15
Pet CPR & First Aid Authorization* This field is required.In the event that my pet stops breathing or experiences cardiac distress during grooming, I authorize trained staff at Tughill Pet Grooming LLC to perform pet CPR and basic first aid until veterinary care can be obtained.
Name of Pets that can receive CPR/First Aid
Please Select
Please Select
Yes
No
Do you give permission in case of emergency
Please initial to acknowledge
16
Veterinary Emergency Authorization* This field is required.If my pet becomes ill or injured during the grooming process and I cannot be reached, I authorize Tughill Pet Grooming LLC to seek veterinary care. I understand that I am responsible for any veterinary costs incurred.
Preferred Primary Vet and Phone Number
Preferred Emergency Vet and Phone Number
Please Select
Please Select
Yes
No
Do you give permission in case of emergency
Please initial to acknowledge
17
Vaccination Acknowledgement* This field is required.For the safety of pets and groomers, current vaccinations are highly recommended, including rabies, distemper, bordatella, lepto. Also strongly suggest up to date flea and tick/heartworm preventives By signing below, I acknowledge that I have been informed that vaccinations are recommended for pets receiving grooming services.
Please initial for acknowledgment
18
Home Environment Agreement* This field is required. Because grooming is performed inside the client’s home, the owner agrees to: • Provide a safe, clean, and adequate space for grooming• Keep other pets and small children away from the grooming area unless discussed• Inform the groomer of any known behavioral or medical issues with the pet. **If you are sick please reschedule your appointment**
Please initial for acknowledgment
19
Right to Refuse Service* This field is required. Tughill Pet Grooming LLC reserves the right to refuse or stop grooming services at any time if the pet’s behavior, health condition, or home environment presents a safety risk to the pet or groomer. If a grooming appointment must be stopped or refused due to aggression, severe stress, unsafe conditions, or other safety concerns, the full grooming price will still be charged, as time, travel, and scheduling have already been reserved for the appointment.
Please initial for acknowledgment
20
Appointment Availability & Cancellation Policy* This field is required.If the groomer arrives at the scheduled appointment and the client is unavailable(up to 15 minutes past appointment time), the pet cannot be located, or the pet cannot be groomed due to circumstances within the home, the appointment will be treated as a same-day cancellation and 100% of the grooming fee will be charged. Cancellation fees apply as follows: • Under 48 hours notice: 25% of the total appointment cost• Under 24 hours notice: 50% of the total appointment cost• Same-day cancellation or missed appointment: 100% of the total appointment cost Any cancellation or missed appointment fees must be paid before booking future appointments with Tughill Pet Grooming LLC.
Please initial for acknowledgment
21
Photo Release (Optional)* This field is required.I give permission for Tughill Pet Grooming LLC to photograph my pet for marketing or social media.
YESNO
22
Payment OptionsWe accept Cash and checks! Checks must be made out to Mary Witzigman or Tughill Pet Grooming We also do accept card, PayPal, Venmo or cashapp but a 3.6% charge will be added to total. Do you understand this?
YESNO
23
Additional InformationPlease list any information the groomer needs to know. Such as allergies, scents, and/or special requests. Please also inform us on any heart issues or medications the pet may have or take!
Huge
Large
Normal
Small
Ok
Ok
24
Owner AgreementI certify that the information provided is accurate and that I agree to the policies listed above.
Type legal name. To be used as signature
25
Contact usYou can reach us by texting: 423-973-1568 Email us at: tughillgrooming@gmail.com or find us on Facebook: Tughill Pet Grooming House calls Do you understand that we do NOT accept phones due to loud work environment and focusing on our clients the best we can while caring for their pets?
YESNO
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