Grooming Form

Save time during your next appointment! Complete your required grooming form online from any device at any time before your visit.

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Grooming Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Client Information

Name *

First

Last

Email *

Phone *

Patient Information

Patient Name *

Species *

Breed

Weight

What type of grooming procedure is being done today? *

Are there any specific problems to address/be aware of or procedures to be performed during the grooming? *

I understand that a current rabies and distemper (and Bordetella for dogs) are required upon admission into Animal Care Center of Carters Creek. *

I understand

I understand that a negative fecal must have been done in the last 6 months for dogs and 1 year for cats. We also require a CIV be current within the last year. *

I understand

Is the pet UTD on required vaccines and annual exam? *

I understand that in the event fleas are noted on my pet, Animal Care Center of Carters Creek will treat with appropriate parasite control medication while my pet is in the hospital, and I will be charged for the medication. *

I understand

Today's contact number for when pet is ready for pick-up *

EMERGENCIES: If the need for emergency care arises, I give my permission for such care to be administered as deemed necessary by the on-duty veterinarian at Animal Care Center of Carters Creek. *

I DO give permission
I DO NOT give permission

Date *

Signature *

Clear Signature

Name

*This promotion is valid for new clients only and may be used once per client. Cannot be combined with other offers or promotions. Other restrictions may apply.

Grooming Form

Grooming Form

Client Information

Patient Information

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