The Laundromutt Grooming — New Client Grooming Agreement

The Laundromutt Grooming — New Client Grooming Agreement

Complete your pet’s details and review the grooming, emergency, and consent agreements before signing.
Pet Parent Information
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email
example@example.com
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Referred by
Pet Information
More than one dog? Fill out this section for your first dog and list the others in ‘Additional dogs’ below.
Pet's Name
Breed
Age
Sex
Markings / Color
Spayed/Neutered
Groom Frequency
People Friendly
Animal Friendly
Medical Conditions
Additional dogs
Vet and Vaccinations
Vet Hospital
Vet Phone
Please enter a valid phone number.Format: (000) 000-0000.
Vet Address
Vaccination exemption
Rabies Expiration Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
DHPP/DHLP Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Bordetella Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upload Vaccination Records

Cancelof
Emergency Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Agreements
Emergency Care Authorization
I authorize emergency veterinary care.
Pickup and Drop-Off
Latest pick-up time I'm available

Hour Minutes

AM/PM Option
I agree to the Pickup and Drop-Off policy.
Cancellation and Rescheduling
I agree to the Cancellation and Rescheduling policy.
Release and Consent
I agree to the Release and Consent.
Matting Release
I have read and understand the risks associated with matting and authorize The Laundromutt Grooming to proceed accordingly.
Is your pet a puppy or senior?
Puppy and Senior Grooming notice
I acknowledge the risks of grooming my puppy or senior dog.
Photo Consent
Photo permission
Signature
Certification
Signature
Printed Full Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

The Laundromutt Grooming — New Client Grooming Agreement

Pet Parent Information

Pet Information

Vet and Vaccinations

Emergency Contact

Agreements

Signature