Pampering 4 Paws Grooming Information and Consent Form
Your Name *
Your answer
Your Email *
Your answer
Address *
Your answer
Home Tel *
Your answer
Mobile Tel *
Your answer
Pets Name *
Your answer
Gender
Pets Approx Date of Birth *
Approx month and year
Your answer
Breed or Breed/Mix *
Your answer
Colour/Markings *
Your answer
How long ago was his/her last groom *
Your answer
Approximate date of last flea treatment:
Your answer
Approximate date of last worm treatment
Your answer
Is your dog up to date with his innoculations? *
Required
Any medical conditions/medication? eg skin problems. (N/A if not applicable) *
Your answer
Any behavioural issues? eg nervous, aggressive. (N/A if not applicable)
Your answer
Vets Name, Address and Telephone Number
Your answer
Grooming Instructions
Your answer
Should I find a tick(s) on your dog would you like me to remove it with a Tom O Tick tick remover? *
I will not be able to continue the groom if a tick is present. If you would prefer that I did not remove the tick I can call you and you can come and remove it yourself.
Your answer
How did you find us?
Your answer
What food do you feed your dog?
Photographs may be taken of your dog and used in before and after shots on our website. Do we have your consent for this?
Anything else? (N/A if not applicable)
Your answer
Declarations
I request that the grooming be completed in accordance with the instructions outlined above or discussed on the day and understand that whilst every effort is made to produce the visual effect that I expect this may not be as I had mentally visualised. *
Required
I understand that if any aggressive behaviour is shown by my dog then restraints (e.g. muzzle), will be used in the grooming process. In extreme conditions the grooming process will be stopped, and I accept the fee will still be payable. *
Required
I agree that Pampering4Paws may carry out First Aid on my dog if so required. If I cannot be contacted in an emergency and my dog requires urgent veterinary attention then I authorise Pampering4Paws to take my dog to the vets. Unless it can be shown that Pampering4Paws are liable, all costs in connection and in carrying out this instruction will be at my own expense. *
Required
I certify that I am the dog’s owner and have the authority to execute this consent. I accept responsibility for the fee and agree to pay this on collection. I am aware that if I cancel without giving 24 hours notice then a cancellation charge may be made. *
Required
I the customer will notify Pampering4Paws on my next visit, if any information changes regarding the condition or health of my dog, or my personnel details. *
Required
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