Peachy Paws Grooming Intake Form
Client and Pet Information
Owner's Name (first and last):
*
Phone number:
*
Address:
*
Email Address:
*
Secondary Contact (first and last)
*
Secondary Phone Number:
*
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Pet Information
Pet's Name:
*
Species:
*
Please Select
Dog
Cat
Breed:
*
Age:
*
Weight:
*
Sex:
*
Please Select
Male
Female
Spayed/Neutered?
*
Please Select
Yes
No
Health History and Allergies: Please describe any past AND current medical conditions, allergies, or behavioral issues.
*
Veterinarian Name:
*
Veterinarian Contact:
*
Current on Vaccinations? A copy of your pet's vaccination records will be required before booking.
*
Yes
No
Please upload a copy of your pet’s vaccination records in the field below. Pets older than 4 months must be up to date on their vaccine's including their yearly rabies vaccine.
*
Upload a File
Drag and drop files here
Choose a file
Rabies certificate/Vaccine records
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Grooming History
Has your pet been professionally groomed before? If yes, how often does your pet get groomed?
*
What is your pet’s temperament during grooming? Please be specific.
*
What is your desired haircut for your pet? (If applicable)
Submit
Should be Empty: