Patient Grooming Agreement

    Please enter Your Name:
    Pet’s Name:
    Your Email:

    Please leave a phone number where you can be reached if the groomer has additional questions about your pet.
    Contact number:

    Please choose one option:

    Spa bath only (includes luxury spa bath, pedicure and ear cleaning)Feline grooming with spa bath (includes haircut, luxury spa bath, pedicure, ear cleaning, anal gland expression)Canine grooming with spa bath (includes complete shave down, luxury spa bath, pedicure, and ear cleaning.)

    Additional Services Offered:

    Dremel Nails ($10) – provides a filed edge to complete a pedicureAnal Gland Expression - Internal ($15)Nail Polish ($10) – freshly painted pedicure in a variety of colorsDeshedding Treatment ($10-30) – removes the undercoat to decrease shedding

    Medical Services (Please Choose One)

    My pet is up to date on their physical exam at Fullwood Animal Hospital, vaccinations and intestinal parasite exam.My pet is due for services and I authorize Fullwood Animal Hospital to perform these services during my pet’s stay.

    Emergency Services – please choose ONE of the following options:
    In the event that my pet undergoes cardiac arrest (heart stops beating) or respiratory arrest (stops breathing) while staying at Fullwood Animal Hospital, I authorize the following CPR code:
    CPR: medical intervention involving intubation, IV catheter placement, chest compressions, oxygen therapy and medications such as epinephrine, atropine, etc. Any costs associated with emergency treatments are incurred at the owner’s expense.DNR: No resuscitation – heroic efforts will not be used to save my pet.

    Mandatory - Please read and check EACH option below.

    Optional

    If you would like to tip the groomer, please remember to bring cash at pickup.

    Signature: