New Client Registration Form

All New Clients Please Fill Out This Form

We Look Forward to Pampering Your Pet!

Please use our Online Scheduling Page

to make your pet's next grooming appointment.

Owner Information

* Your First & Last Name

* Home Phone

* Your Street Address:

Cell Phone

* City & State

Work phone

* Zip Code

* Your Email Address

Your Pet's Information

* Your Dogs Name:

* Is Your Dog

Male

Female

* Is Your Dog

Neutered

Spayed

Neither

* Your Dog's Breed

* Your Dog's Date of Birth

* What Color is your Dog?

* Your Dog's Weight

* Veterinary Hospital Name & Phone

* Medical Problems

* Behavioral Problems

* Date of Last Vaccinations

Your Second Pet's Information

* Your Dogs Name:

* Is Your Dog

Male

Female

* Is Your Dog

Neutered

Spayed

Neither

* Your Dog's Breed

* Your Dog's Date of Birth

* What Color is your Dog?

* Your Dog's Weight

* Veterinary Hospital Name & Phone

* Medical Problems

* Behavioral Problems

* Date of Last Vaccinations

Do you have other pet's that will be getting groomed with us?

Your Pet's Grooming History

* When was your Dog's last professional grooming?

Would you like to schedule regular grooming appointments with us?

Yes

No

Does your Dog have a regular groomer?

Yes

No

* Does your Dog have Fleas that you are aware of?

Yes

No

I am not certain

Why are you looking for a new groomer for your Dog?

* Has your Dog ever bitten his/her groomer?

Yes

No

What kind of trim would you like for your Dog?

Breed Standard Style

Short & Easy Care

Untrimmed & Scruffy Looking

* If my Dog's coat is Matted or Tangled and requires extra time spent on grooming, I agree to pay the current de-matting fees.
If my Dog is found to have Fleas, I agree to pay for an all natural Flea Treatment.

I Agree

Emergency Info

Emergency Contact Name

Phone #

Names of others that may pick your Dog up at the Salon

* I give the salon, Pet Styles by Jennifer and it's Owner or Staff
permission to seek emergency medical treatment
for my Dog if deemed necessary by the Owner or Staff.
This treatment will be at my expense.

I Agree to these terms

Comments or Questions

* How did you here about us?

* Would you like us to contact you to schedule a grooming appointment for your pet?

Yes

No

* How would you like us to contact you?

Email

Telephone

* I signed up for the Pet Styles by Jennifer email list

Yes

Please add me to the email list

No, I do not want to recieve current specials & info through the Salon's email list

* Would you like a tour of our Salon before your Dog's grooming appointment?

Yes

No

* Indicates Response Required