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Grooming Form - Hernando Animal Clinic

First Name

Last Name

Mobile Phone

Preferred contact method for today:

Preferred contact method for today:
A
B

Email

Patient Information

Pet's Name

Pet's Age

Does your pet need to be seen by a doctor today?

Does your pet need to be seen by a doctor today?
A
B

Pet's Breed

Pet's Weight

Grooming Requests: Please be as specific & complete as possible

Head/Ears

Body

Feet/Tail

Special Instructions

Please attach any photos you would like to share with the groomer

If you have previous medical records available to upload, please provide a PDF, image, or document file. If you only have a physical copy, please bring it to the appointment.

Authorization

Please be aware we cannot promise completion times for your pet. Please be prepared for your pet to spend the entire day with us, and you will be contacted when your pet is ready to go home. All prices given for grooms are ESTIMATES and final pricing is at the discretion of the groomer. If you would like to be contacted with a firm price prior to your pet being groomed, please notify the receptionist. AUTHORIZATION: ALL FEES ARE DUE AND PAYABLE AT THE TIME SERVICES ARE RENDERED. We accept cash, Visa, Mastercard, Discover, and American Express. In addition, we offer third-party financing through CareCredit and ScratchPay. Please notify a receptionist if you need to apply for third-party financing prior to the start of your appointment. Current vaccinations by a licensed veterinarian are required for the admission of your pet to our hospital. Owner administered vaccinations are not acceptable. This includes admission for elective surgery, boarding, grooming, and well animal care. Proof of vaccinations is required prior to admission and is the responsibility of the client. We require Bordetella to be given within the last six (6) months, DHLPP within the last twelve (12) months and rabies vaccine to be current (1 or 3 years). I agree to allow the doctors and staff of Hernando Animal Clinic to treat my pet and I accept responsibility for all accumulated fees associated with the care that my pet(s) receive. I understand that I am responsible for payment in full prior to discharge according to Hernando Animal Clinic policy and will be held responsible for service or collection fees if balance is not paid in full. I have read and accept the above-mentioned terms and conditions by attaching my full name below as my digital signature.

e-signature

Signature