Customer Information

Pet Owner’s Name:______________________________________
Address:______________________________________ City:_____________________ Zip Code:_______
Home phone #:_________________________  Cell phone #:_________________________________
Can we send you text reminders for your appointments? ________Yes _______No

Email Address: ______________________________________
Alternate contact name & number:______________________________________________________
Are you, your pet, or anyone in your family allergic to any of the following oils: 
Aloe____ Shea Butter____ Jojoba______ Avocado_______ Emu oil_______   None ________
Pet Information
Pet’s Name:______________________________  Breed:_______________________________
Sex: Female  ____ Male    _____ Age:_________  Veterinarian:_________________________________
Health issues: (such as allergies, chronic ear infections, arthritis, hip dysplasia, diabetes, blindness, deafness)________________________________________________________________________
Do you give Furry Tails permission to use your pet’s picture on our website, Facebook page, or for other business purposes?  ______Yes _____No
Any other important information: (such as hates nails done, afraid of water, needs to urinate often, trouble standing)__________________________________________________________
Special products: (such as vet shampoos, vet ear wash or cleaner)_______________________________
Has your pet ever bitten?  _________Yes  _________No (If yes, please explain the circumstances)
____________________________________________________________________________________
Vaccine Expirations:  Rabies:________________Distemper/Parvo_________________Bordatella:____________ 
FVRP:____________________________ FELV:_______________________
What type of groom would you like for your dog today? (circle one)   Full Haircut   or    Bath & Neaten
How did you hear of us? ______________________________________________

When you make an appointment we block off that time and that crate for your pet.  When you do not give us notice we cannot fill that spot with another pet, and that results in lost wages.  If you do not call and do not show we will require nonrefundable prepayment for your next appointment. For the second time you miss an appointment it is $20 fee in addition to the nonrefundable prepayment for your next groom. 
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                                Date						Signature