Grooming Application Please have your veterinarian fax us a copy of your pet’s current vaccinations to (717) 397-0731 or bring a copy with you. We must have veterinarian letterhead on the vaccination schedule. We require Rabies, Distemper, and Bordetella. Contact InformationPet Parent's Name* First Last Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Home PhoneCell PhoneCell ProviderBest way to reach you?Email* Veterinarian Office*Veterinarian Phone NumberEmergency Contact InformationPrimary Emergency Contact(list someone other than yourself or spouse)RelationshipPrimary Phone NumberYour DogPet's NameBreedDate of BirthCurrent AgeColorWeightGender* Male Female Neutered/Spayed?* Yes No Has your dog been groomed before? Yes No If so, why are you switching to a different groomer?Has your pet had any issues in the past with grooming or are you aware of any issues they may have now?(i.e. aggressive tendencies, likes/dislikes, etc.)Does your pet have any medical conditions the groomer should be aware of?(i.e. heart condition, arthritis or bad hips, allergies to shampoo or cologne, etc.)Would you like a minor trim or a full trim on your pet?If your pet is receiving a full groom/trim, how much coat would you like removed?(i.e. half the length, one inch, 1/2 inch, etc.)If you own a dog with a breed specific haircut, do you want that done? Yes No (i.e. Westie, Cocker, Schnauzer, etc.)Do you want a puppy cut, which trims the pet the same length all over, with the head and face slightly longer? Yes No Do you have any additional instructions for your pets grooming visit?(i.e. Leave ears long, keep hair on legs longer than body, etc.)Terms & ConditionsPlease review our grooming policies and be aware that all grooming instructions are subject to change when the groomer meets your pet or while grooming your pet. There may be something the groomer cannot do because of your pet’s coat condition, behavior, or health.Consent* By submitting this form, I agree that I have read and agree to the above.CAPTCHA Download Printable PDF