New Customer Enrollment Application

Please complete the enrollment form below to save time during check-in.

Please note: owners must provide proof of vaccines before their pet can obtain services (some exclusions apply to grooming clients). Vaccine requirements are as follows:

Dogs (6 months and up)

Puppies (Less than 6 months)

Cats

Name *

First

Last

Complete Address *

Please include city and zip code.

Phone *

Email *

Would you like to sign up for our newsletter?

Yes! I want to hear about special promotions, events, and updates
No

Emergency Contact *

First

Last

Emergency Contact Phone # *

Veterinarian/Clinic Name

Owner must provide proof of up to date vaccines

Vet Clinic Address

Vet Clinic Phone #

Additional Pickup Authorization

Indicate above the names of any additional people allowed to pick up your pet.

My Pet is a:

Breed/Description

Sex

Pet Name

Pet Date of Birth

Pet Weight

Spayed or Neutered?

Some services require pets to be altered.

Please describe any chronic or physical problems we should be aware of:

My second pet is a:

Breed/Description (second pet)

Sex (second pet)

Pet Name (second pet)

Pet Date of Birth (second pet)

Pet Weight (second pet)

Spayed or Neutered? (second pet)

Some services require pets to be altered.

Please describe any chronic or physical problems we should be aware of: (second pet)

If customer referral, who referred you?

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