NEW CLIENT FORM

 

For less waiting time before your first appointment, please print and fill out all of the sections of this form at home. Then bring the completed form and your pet's current vaccination records with you to their first appointment or nail trim.

In addition to his form we require that customers sign a Waiver when coming into our shop.

 

PET PARENT NAME:

CURRENT ADDRESS:

 

EMAIL:

 

HOME PHONE #

CELL (MOBILE) #

 

VET PRACTICE/NAME:

 

ADDRESS:

 

PHONE #

FAX #

 

NAME OF A SECONDARY CONTACT:

 

PHONE #(s)

RELATIONSHIP:

 

PET NAME:                                                     

BREED & COLOR:

YEAR OF BIRTH: 

                                            

GENDER: MALE        FEMALE                             SPAYED / NEUTERED:    YES     /    NO

 

RABIES VACC. EXPIRATION DATE:

 

SPECIAL CARE INSTRUCTIONS:

 

 ANY SKIN CONDITIONS?                                             ALLERGIES (if any):

 

SIGNATURE OF PET PARENT:                                                         Date:

 I agree to allow Amherst Dog Wash LLC to take and use pictures of my pet(s) in promotional material / on social media outlets (e.g. before and after pictures for groomer’s public portfolio)

 YES:____________          NO:_____________