Pet Grooming Consent Release Form

Senior Pet Release Form
Pet Owner Details
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Pet Details
Pet's Name*
Breed of Pet
Pets DOB
Does your pet hav any known medical issues?*
Is your pet taking any medications? If yes please list/*
Review of our Senior Pet Policies

Please review, sign and date
I understand that my pet(s) has/have medical condition(s) and/or is/are senior(s). I am aware that grooming can cause stress that can exaggerate or expose new problems, or even lead to a serious medical event or death.

I understand there are mental and behavioral changes in senior dogs or dogs with medical conditions, and they are groomed for comfort only and not appearance.

I release the JRLN dba Perk-N-Pooch from any liability should any problem/medical issues occur.

I am solely responsible for any and all medical bills related to my dog, and should an emergency arise, I give permission to Perk-N-Pooch to seek veterinary care at the nearest veterinary clinic. I understand that Perk-N-Pooch has the best interest of my pet in mind and will do everything to keep my pet safe.

If the Perk-N-Pooch feels that grooming will be too stressful for my pet, the groom will be stopped immediately and I will be contacted.
Acknowledge*
Type Name
Should be Empty: