Grooming Consent Form

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

Grooming Consent 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

Phone *

Email *

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 Avenue of the Saints Animal Hospital. *

I understand

I also understand that a current (within a calendar year) heartworm test and stool check for intestinal parasites must also be up to date. *

I understand

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

I understand that in the event fleas are noted on my pet, Avenue of the Saints Animal Hospital 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 Avenue of the Saints Animal Hospital. *

I DO give permission
I DO NOT give permission

Date *

Signature *

Clear Signature

Email

Waverly

Charles City

Online Pharmacy

Grooming Consent Form