WELLINGTON ANIMAL HOSPITAL

GROOMING REGISTRATION FORM

Requested Grooming Date:

Owner's Name:

What Number Can We Reach You At Today?:

Owner's Address:

Street 1:

Street 2:

City:

State:

Zip:

Are You A New Grooming Client?

Yes

Do You Have A Preferred Groomer?

Yes

If "Yes", Please Specify Preferred Groomer:

What Is Your Pet's Name?:

Please List Any Special Instructions Regarding Grooming:

By Clicking The "Submit" Button, I Certify That I Understand All Of The Following: All fees are due and payable upon completion of services. A cancellation charge will be added to my next groom for a no-show. Fee does not include gratuity.