Appointment Request Form

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Use the form below to request an appointment with Juleah. Most requests will receive a response within the same business day.

Preferred Appointment Date and Time
*

YYYY

Time

Your First and Last Name
*

Your Phone Number
*

Your Pet's Name
*

Your Pet's Age
*

Your Pet's Breed
*

Your Pet's Approximate Weight
*

Date of Your Pet's Last Rabies Vaccination
*

YYYY

Service Requested
*

Nail Trim

Bath and Brush

Bath and Trim

Bath and Full Haircut

Additional Services Requested (Optional)

Flea and Tick

Teeth-brushing

Deskunking

Dematting

Agree to the statement below
*

I understand that my pet must have an up-to-date rabies vaccination, and I must be able to provide proof of vaccination at the time of my appointment. (Required by CA and EDC law)

Required

Agree to the statement below
*

I have disclosed any known health or special concerns in the box below.

Required

Anything else we should know?

Submit

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This form was created inside of JB Grooming, LLC.