Client Intake & Consent Form
Cornwall Claws And Paws Grooming
Client Information
Legal name:
First Name
Last Name
Preferred name:
First Name
Last Name
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pet Information
Pet name:
Species:
Breed or mix:
Age or date of birth:
Vaccination status and expiry dates:
Sex:
Colour and identifying features:
Veterinarian clinic and phone:
Alternate emergency contact (name and relationship):
Alternate emergency contact phone:
Format: (000) 000-0000.
Health, Behaviour & Handling Information
Please disclose any ongoing information that may affect the safe handling of your pet. The details below are ongoing pet information, not appointment-specific questions; please update them when something changes.
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Medical conditions, injuries, or recent surgery
Medications
Mobility concerns
Nail or paw sensitivities
Fear or anxiety
Handling sensitivities
Reactivity
Biting history
Allergies
Vaccination Requirement
Pets must have up-to-date vaccinations in accordance with the grooming shop's current requirements. Proof of vaccinations will be required before or at the pet's first appointment. Clients must provide updated proof if vaccination records change.
One-on-One Appointment Request
If your pet is more comfortable with a quieter environment, you may request a one-on-one appointment. This means no other pets will be present in the grooming area or entering while
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your pet is being groomed. One-on-one appointments are subject to availability and will be confirmed separately for each visit.
I would like to request one-on-one appointments with no other pets present or entering during my pet's appointment.
Client Agreements & Waivers
Please check each item to confirm your agreement.
I confirm that my pet's vaccinations are up to date, and I understand that proof of vaccinations is required for the first appointment and may be requested again if records change.
I confirm that I am the pet's legal owner or an authorized caregiver and have permission to consent to grooming services.
I confirm that the information I have provided is accurate and complete, and I will update the business if my contact information or my pet's health, behaviour, or handling needs change.
I understand that grooming involves normal risks, including stress, movement, minor nicks, temporary discomfort, bleeding, nail splitting, or breakage, particularly when nails are long, dark, damaged, or overgrown.
I understand that animals can move or react unexpectedly, even when reasonable care and safety measures are used.
I authorize the service provider to use reasonable, humane handling and restraint techniques when needed for safety. I understand that veterinary sedation or medication will not be provided.
I agree to disclose any known history of fear, anxiety, reactivity, aggression, biting, or sensitivity to handling before services are provided.
I understand that the service provider may pause, stop, or decline a service if continuing could create a safety or welfare risk for my pet, the service provider, or another person.
I accept responsibility for risks or costs resulting from health conditions, injuries, or behaviour that I did not disclose, or that could not reasonably have been anticipated.
If my pet causes injury or property damage, I accept responsibility for reasonable related costs, subject to applicable law.
In an emergency, if I cannot be reached, I authorize the service provider to seek appropriate veterinary assistance for my pet. I understand that I am responsible for veterinary, transportation, and related costs.
I understand that this agreement does not waive responsibility for negligence, intentional misconduct, or any responsibility that cannot legally be waived.
I understand that this form is an ongoing consent and intake record, and that I can ask questions or request updates to my information.
Optional Photo & Video Permission
Optional Photo & Video Permission Selection
I consent to photos or videos of my pet being used for business marketing.
I do not consent to photos or videos being used for business marketing.
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Acknowledgement & Signature
I have read and understood this form, including the client agreements and waivers, and agree to its terms.
Client signature:
Printed name:
First Name
Last Name
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Business representative:
First Name
Last Name
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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