Grooming Release Form

Owner Name: *

Address: *

City: *

State: *

Zip: *

Cell Phone: *

Email: *

Emergency Contact & Phone #: *

Dog’s Name: *

Breed: *

Sex: *
MaleFemale

Spayed/Neutered? *
YesNo

DOB: *

Weight: *

Has dog been to the groomer before? *
YesNo

Has dog ever bitten anyone? *
YesNo

Any skin sensitivity/allergies?

Chronic ear infections/problems?

Any overall health concerns?

Your dog is very important to us. Barks on the Boulevard would like to assure you that every effort will be made to make your dog’s grooming experience as safe and pleasant as possible. Safety comes first for everyone during the grooming process for people as well as the dogs. Please initial each paragraph and sign at the bottom of the form.

Vaccinations: All pets are required to be current on all vaccinations in order participate in off leash play (must pass Temperament Test). Please fax to 315-266-1217 or bring in proof of Rabies Vaccine prior to appointment. *

Health or Medical Problems: Occasionally grooming can expose hidden medical problems or aggravate a current one. This can occur during or after grooming. The dog’s owner upon signature of this contract/agreement will cover all medical expenses for veterinary care. We also reserve the right to refuse service to customers whose dog might pose a threat to us or the other dogs in our care, whether it’s an aggression problem, health problem or parasite problem. *

Accidents/Medical Emergencies: Although accidents are rare, there is a risk when dealing with animals. Grooming equipment is sharp, and although we use extreme caution in all situations, possible problems could occur if your dog is wiggling or moving around, including cuts, nicks, scratches, quickening of nails, etc. Your dog’s comfort and safety is our number one priority. In an event that an accident occurs, you will be notified of the accident. If Barks on the Boulevard feels that the accident is serious, and the owner is not available, we will seek immediate veterinary care at Burrstone Animal Hospital in New Hartford, NY. *

Additional Fees: We reserve the right charge additional fees for services over and above the norm, not covered by our standard rates. These additional fees would include de-matting/de-shedding, flea baths, medicated baths etc. Pricing given over the phone is only an estimate. The final price will be given at the time of check out after the groom has been completed. *

Fleas and/or Ticks: Barks on the Boulevard, strives to be a flea-free facility. If you dog has, any fleas, they will be given a flea bath at your expense of an additional $10.00. Ticks will be removed free of charge, and you will be notified if any are found. *

Aggressive Dogs: Owners MUST inform Barks on the Boulevard if you dog has bitten, or is aggressive towards people, other dogs, or specific grooming procedures. In the event that your dog becomes aggressive during a grooming session, Barks on the Boulevard reserves the right to refuse grooming services, or stop the grooming session at any time before or during the grooming session. We do not muzzle unless your dog gives us a reason to. A muzzle may be used as a last resort, which does not harm the dog in any way, and may allow the grooming session to continue. *

Matted Coats: Dogs with severely matted coats require extra attention. Mats are very painful to the dog, and will ultimately cause damage and even: tear the dog’s skin, and could provide a breeding ground for infection and parasite (flea & tick) infestations. In addition, matted hair does not allow for air circulation to the skin, causing hot spots, bacterial and fungal infections. Mats are difficult to remove and may require the dog to be shaved. Removing a heavily matted coat can cause bruising, nicks and abrasions as we are working very close to the skin, even though we are extremely cautious. After effects of mat removal can include itchiness, skin redness, self-inflicted, abrasions, and in some cases, failure of the hair to re-grow. In some cases, the dog may even experience brief behavioral changes. Prevention is the best defense by scheduling regular grooming sessions. If you pet needs to be shaved, we will contact you to let you know. By initialing this, you acknowledge that you agree to this procedure, if necessary. *

Cancellations/No-Shows: No-Shows and cancellations without a 24-hour notice are subject to a $20.00 "No-Show" Fee. No-shows and cancellations at short notice leave an empty grooming appointment that could have been used by another customer. *

Photographs: This release form authorizes Barks on the Boulevard to take photos of your dog for our website and/or Facebook page and any other advertising medium. *

Satisfaction: Your satisfaction is important to us. If you are unhappy for any reason, and would like something adjusted, we will be happy to make the adjustment at the time of pickup. *

I have reviewed this Service Contract for accuracy and understand the contents. I affirm that I am the rightful legal owner of the dog for which grooming services are being rendered. I authorize this signed agreement as valid approval for the future grooming services, permitting Barks on the Boulevard to accept reservations without additional signed contacts or written authorization. I understand that prices are subject to change. I have read, signed and agreed to the above.

Signature of Owner: *

Date: *

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