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Hamilton Plaza Animal Hospital
Grooming Form
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Reason for Visit
Your answer
Date
MM
/
DD
/
YYYY
Your Name
Your answer
Pet Name
Your answer
Age
Your answer
Client Number (If you know it)
Your answer
Sex
Female
Male
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Altered
Yes
No
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Breed
Your answer
Color
Your answer
All grooms/baths include Nail Trim / Ear Cleaning / Anal Gland Expression / Bows or Bandanas
Grooming Instructions
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In the event the groomer can not contact you and finds your pet has severe matting, do we have your permission to do whatever is deemed necessary for your pet up to and including shaving?
Yes
No
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Please check any other services you would like for your pet:
FURminator
Dremel Nails
Teeth Brushing
Medicated Shampoo
Heartworm Preventative
Yes
No
Not sure
Other:
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Flea/Tick Preventative
Yes
No
Not sure
Other:
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Please note that we are a flea and tick free environment. If any are noted on your pet, we will treat at your expense.
Digital Signature
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Contact Number
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