Appointment Request Form PERSONAL INFORMATION Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country PETS INFORMATION Pets Name * Pets Age * Pets Breed * Pets Weight * Any allergies or sensitivities to shampoos or products? * Any history of biting or aggressive behavior? * Pet summary * Check all that apply Has Fleas/Tics Matting Hair Loss Dandruff/Flakey Skin Is Currently Pregnant/In Heat Previous Anxiety/Nervousness At Groomer None of the above Desired Services * Full service bath Full service groom Ear hair removal Gland expression Sanitary shave Paw pad trim Special requests Any comments or questions? Thank you!
