Grooming Release Form

• First Name*

  Please enter your first name.
• Last Name*

  Please enter your last name.
• Best number to reach you on the day of grooming*

  Please enter your phone number.

  This isn't a valid phone number.
• Grooming appointment date

  (if appointment has not been scheduled please call (910)799-2970 to schedule.*)

• Pet's Name
• Breed

• Type Of Pet*

  • Dog
  • Cat

  Please make a selection.

  (Please note that it is a requirement for cats to be chemically sedated for grooming. Please do not feed your cat after 8pm the night prior to their grooming appointment. Water may be left available until the morning of the appointment.)

• Is your pet on monthly flea control?*

  • Yes
  • No

  Please make a selection.

  (Please note that if fleas are noted, your pet will be treated immediately with an appropriate product. There will be an additional charge for any flea treatment.)

• If yes, what kind?
• Grooming details/requests (please be as specific as possible):*

  Please enter a message.

• Would you like your pet to get complimentary fragrance?

  • Yes
  • No
• If yes, what is your fragrance preference? Italian Lemon and Sugarcane Blueberry Pie Coconut and Pineapple Vanilla and Black Raspberry Lavender and Chamomile Citrus and Pomegranate Spring Water and Cucumber Groomer's Choice

  Please make a selection.

• Would you like your pet to receive a complimentary bandana? (Dogs only)

  • Yes
  • No

Drop off time for grooming is anywhere from 7:30am-8:30am.

• Drop off time*

  Please enter drop off time

Pick Up Time: The groomer will contact you to let you know that your pets grooming is finished. The groomer aims to have all pets finished between 1:30pm and 3:30pm.

Terms

• Please note, that your pet will likely not be groomed straight through and will need to stay with us for several hours at minimum. We will groom all of the pets in our care gradually throughout the day as it is the most efficient and often least stressful way. Pets that are sedated will need to be picked up at the end of the day so that we can ensure that they have safely recovered from sedation.

  We care about your pet's safety and well being, and want to assure you that every effort will be made to make your pet's visit as pleasant as possible. If your pet has severe matting of hair, the skin underneath may be inflamed. Matting leads to an increased risk of injury such as nicks and clipper irritation. Grooming may also expose hidden medical problems or aggravate current ones. While we make every effort to avoid such complications, they occasionally do arise as a result of grooming.

  We will make every effort to produce the haircut/appearance you desire for your pet but no guarantees can be made due to varying coat types and potential matting of hair

  I certify that am the owner or authorized agent for the owner of the above named pet and I authorize Needham Animal Hospital to admit this pet to their hospital for grooming services and neccesary treatments.

  I understand that any medical problems will be treated as deemed best by the veterinarian on duty. Should the hospital not be able to reach me within a reasonable amount of time in case of medical emergency, I authorize the attending veterinarian to administer the minimum medical treatment required to ensure the health and safety of my pet.

  I accept the financial responsibility for treatment and understand that payment is due in full at the time of discharge.I have read and understand the hospital's policies.

  • I agree to the terms above*

  Please make agree to terms
• Signature*

  Please enter your name.