Client and Pet History/Release Form

Client and Pet History/Release Form

GROUCHO BARKS MOBILE PET GROOMING
Client: ______Phone:______Date: ______
Address ______

Internet address:______

How did you hear about Groucho Barks Grooming?______

Pet's name: ______Nick Name______Breed: ______

Age: ______Sex______

Weight ______

Up to date on Vaccines? Yes____ No_____Explain______

New health code law requires that groomers have on file a copy of pup’s vaccine

history on file.

Do I have permission to contact your vet and have history faxed?______

If so, please call your vet and explain.

Vets “Business” Name:______Phone #______

Any aggressive tendencies? Yes___ No____ Please explain______

Birthdate______

Known conditions______

Known moles, sores on body______

Allergies? Type______Can I give pup a treat?______

Condition of Teeth______Dental Program Ok to initiate? Yes___ No____

Pet’s #2 name:______Nick Name______Breed:______Age:______Sex______

Weight______Up to date on Vaccines? Yes____ No_____ explain______

Any aggressive tendencies? Yes___ No____ Please Explain______

Birthdate______

Known conditions______

Known moles, sores on body______

Allergies? Type______Can I give pup a treat?______

Condition of Teeth______Dental Program Ok to initiate? Yes___ No____

If your 2nd pet doesn’t use the same vet…

Vet’s “Business” Name:______Vet’s name______

Phone #______

At Groucho Barks, your pet's comfort and well-being is very important. To this end, I will never knowingly cause harm to any pet for any reason, especially vanity. Brushing (de-matting) can be painful to a neglected coat, therefore if I deem the coat to be in too terrible shape to safely, painlessly comb-out, the pet owner will be given the option to have me 1) clip out the mats, 2) strip the coat with as short a blade as deemed necessary, 3) not receive grooming with Groucho Barks until the matting is a non-issue.
Client's initials: ______Groucho Barks: ______
I recommend that most pets receive competent professional grooming services every 4-12 weeks, depending on the breed of the pet and the maintenance requirements of their coat. When grooming your pet, health issues may be uncovered/discovered that were previously unknown to the pet parent or have been left untreated by the pet owner. While Groucho Barks will inform you of any findings during the grooming appointment, I am not responsible for any vet bills that result from these findings. Also, during the grooming of pets with extremely neglected coats, it is impossible to foresee moles, warts, and other health concerns unless I have been forewarned. By initialing below, the client and Barbara Buglioli agree that they have discussed a professional maintenance program for grooming and the risks associated with poor coat care.
Client's initials: ______Groucho Barks: ______
Checking the anal sacs (glands) is a courtesy provided during your pet's bath. They will be expressed unless told otherwise. If you wish them not to be done, please initial. ______

8/1/2010 2 of 2 pages