NEW DOG CLIENT REGISTRATION (You must submit a form for each pet.) Fields marked "*" are required. DOG NAME*: AGE*: BREED*: SEX*: SPAYED/NEUTERED?*: ---YESNO ANY KNOWN PROBLEMS WITH GROOMING?: MEDICAL HISTORY (check all that apply): BlindDeafLuxating Patella'sAllergies (food/environmental)Heart MurmurSeizuresPanting or Breathing IssuesKidney DiseaseArthritisSkin Disorder, Hot Spots etc.Thyroid IssuesDiabetesFrequent Vomiting/DiarrheaHip DysplasiaOther PLEASE EXPLAIN IN DETAIL YOUR DOG'S HEALTH CONDITION(S): IS YOUR DOG ON ANY MEDICATION OR SUPPLEMENTS?: IF YES, PLEASE EXPLAIN: OWNER’S FIRST & LAST NAME*: (required) STREET ADDRESS*: ZIP CODE*: EMAIL ADDRESS*: CELL PHONE*: HOME PHONE: EMERGENCY CONTACT NAME*: EMERGENCY CONTACT PHONE*: VETERINARY CLINIC*: HOW DID YOU HEAR ABOUT US?*: (After reading the policies, scroll down to agree and submit this form.) Pet Grooming Release Form & Policies Our staff is dedicated to providing you and your pets the highest quality care in a safe and stress-free environment. To help us serve you better, please ask any questions about our services or other policies. By signing below, you acknowledge you have read and understand our policies and agree to abide by them. You further acknowledge pricing is subject to change. Additional policies are available on our website at www.vipgroomgr.com. Operating Hours Our operating hours are Tuesday through Saturday by appointment only. Any pet that is not picked up within 30 minutes of being notified the groom is completed will be charged an additional fee of $10.00 per 15 minutes for late pick up. Pets must arrive in an approved manner to ensure the safety of your pet and our staff. Payment Policies All payment is due at the time services are rendered and must be collected prior to your pet being discharged. Payment can be made by Cash or Major Credit/Debit Cards. There are no refunds available for any deposits received or for any completed grooming services. You may cancel your grooming reservation by calling and providing a detailed message. We require at least 24 hours notice of cancellation. Any cancellation made without 24 hours notice is subject to an additional charge equal to the cost of the scheduled groom. Medical Information Our first priority is your pet. You are required to inform us of all medical problems your pet has before utilizing our grooming services. Being away from home can sometimes be stressful, especially for new clients and senior pets, and can aggravate or expose a hidden medical problem. We will do our best to contact you first, but in the event of an emergency we will seek immediate medical attention to ensure your pet’s safety. All pets must be free from transmittable illnesses (i.e. upper respiratory, ringworm, etc.) to utilize our services. If your pet displays symptoms of any illness we may refuse any service until your pet is declared healthy by a veterinarian. Any medication administration requires pre-approval by us prior to your pet’s appointment. Fleas & Ticks If your pet is found to have fleas, ticks or parasites they will be treated for an additional charge of $10.00. If multiple animals are brought in to receive our services we will automatically treat all your animals. Additional charges may apply if we need to quarantine and/or perform additional cleaning of our facilities and equipment, or your pet’s carrier and its contents. Grooming We utilize experienced groomers who are trained to recognize symptoms of stress and reserves the right to stop the grooming process prior to completion to ensure the safety of your pet or our staff. Keeping your pet safe and comfortable is our first priority. While we always use extreme caution while grooming your pet, our equipment is sharp and your pet may shift or move unexpectedly causing a possible accident. If an accident does occur, you will be notified as soon as possible. Matting of the hair on your pet may increase the likelihood of stress during the grooming process and may increase the time needed to safely groom your pet. Additional fees may apply for mat removal. Refusal of Service We reserve the right to refuse any service at any time. If we are unable to handle your pet safely or your pet becomes too stressed we may refuse, stop or cancel service at any time. A fee may still be required for any services or partial services performed. Veterinary Information We require our clients to provide us with up to date veterinary information to utilize our grooming services and you must provide us proof of current Rabies vaccination for each pet. A letter of vaccine exemption from your veterinarian may also be accepted. It is your duty to continue to disclose any and all medical and health conditions of your pet. You authorize any present and past veterinarians to share medical information about your pet(s) with VIP Grooming Salon, including but not limited to vaccine records and current medical conditions. In limited circumstances, we may accept a letter of medical exemption on your veterinarian’s letterhead. Any pet that is not fully vaccinated may not be eligible for all services. In the event of an emergency, we will attempt to take your pet to your authorized veterinarian, but we retain the privilege to use a veterinarian of our choice if circumstances require. Any and all veterinary costs will be at your expense. Promotional Use We utilize photographs and video of your pet for our files, internet websites and advertising. All photographs and videos we take of your pet are the property of VIP Grooming Salon. If you wish to opt out of photographs or videos of your pet being used for promotional purposes, please email us at email@example.com. Acknowledgement By submitting my name below, I certify that I am the rightful owner or guardian of the pet(s) for which services are rendered and I agree to adhere to all of VIP Grooming Salon’s policies and procedures. I agree to hold VIP Grooming Salon harmless from damage, loss or claims arising from negligence and any condition of my pet(s) whether known or unknown. These damages, loss or claims shall include, but are not limited to, death and injury. Pre-existing conditions shall include, but are not limited to, illness, previous injury, skin and coat conditions, medical conditions, advanced age and nervousness. I authorize VIP Grooming Salon to act as my agent in the event emergency veterinary services, care-taking and/or transportation is necessary and I agree to pay all costs. I have read and accept this policy for any present and all future services. By typing your name in the box, you are accepting the above release & policies*. (You will also be required to sign a hard copy of this form upon arrival to the salon.) Your Name*: More pets to register? Click HERE to go back to the FORMS PAGE.