Grooming Intake Form Please fill out all required fields for form to properly submit. To check if form has submitted, click "Fill out intake form" button again. "*" indicates required fields Name* Partner/Spouse (Secondary Handler) Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Dog's Name* Dog's Age* Dog's Breed* Dog's Sex*MaleFemaleDog's Weight* Dog's Color* How did you hear about us?* Is your dog neutered/spayed?*YesNoWhat vet do you currently use?* Upload a copy of vaccination records now? (Or email before appointment)Yes, upload nowNo, email laterPlease upload a copy of your dog's vaccination recordsMax. file size: 256 MB.Has your dog ever been prescribed a medication for sedation during the grooming process?* Please list any medical conditions your pet has that you are aware of.* Please list any medications your dog is currently on. Be sure to include monthly preventatives (heartworm and flea) as well as any as needed medications (for anxiety or car rides) and supplements.* Upload a photo of your dog's current look now? (Or email before appointment)Yes, upload nowNo, email laterPlease upload a photo of your dog’s current lookMax. file size: 256 MB.Upload a photo of your dog's goal haircut now? (Or email before appointment)Yes, upload nowNo, email laterPlease upload a photo of your dog’s goal haircutMax. file size: 256 MB.When is the last time your dog was groomed by a professional?* Does your dog have any matting?*Has your dog ever had to be muzzled for a grooming or vet procedure?* Are you interested in creative grooming services?* How soon do you need an appointment?* What days and times are best for you?*What flea and tick preventative is your pet on?* I understand that extra charges may apply if matting, fleas or behavioral problems occur. Please initial.*Please initial at the bottom of each of the following to indicate that you've read and agree to the following terms: I understand that prices vary based on the condition of the coat and breed of the dog. You will be quoted a price once all information is completed and reviewed. Please initial.* I understand that I must pick my dog up within 30 minutes of the time they are finished. Please initial.* I understand I must keep my dog on a regular grooming schedule (at least every 8 weeks). Please initial.* I understand that if I fail to book out my grooming appointments, I may be charged an extra fee to work my dog into the schedule.* I understand that if I fail to give 24 hours notice to cancel my appointment, I will be charged a $25 no show fee. Please initial.*