EmailMe Form - Tails of Success Grooming Request Form

Name

First Last

Name (owner #2)

First Last

Phone *

### - ### - ####

Phone (owner #2)

### - ### - ####

Email *

Email (owner #2)

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

How did you hear of us? *

Emergency Contact (name & phone #) - NOT OWNER *

In the event of an emergency, we will always call the numbers listed for the owners first. Please provide an additional person to call in the event that owners cannot be reached.

Please confirm my Grooming Appointment *

I will call to schedule

My reservation has been booked via phone already

My dog's last grooming appointment at Tails of Success was: *

Within the last 3 months

Over 1 year ago

Within the last year

This is our first appointment

Do you currently use any other services at Tails of Success?

Daycare

Boarding

Training

Dog's Name

Breed *

Age

Date of birth (approximate is okay) *

Vet Hospital

Weight *

Gender *

Male, neutered

Female, spayed

Male, unneutered

Female, unspayed

Color *

Food allergies? *

The grooming package I would like is: *

Spa Grooming Package (includes cut or trim)

Spa Day Package (no cut included)

Please describe your dog's grooming needs, including details about the cut you would like. *

Does your dog have any special grooming or handling needs?

Is your dog matted (this means areas of knotting in their fur)?

Heavily matted

Some matting

Not matted

Is there anything special we should know about your dog?

Has your dog ever bitten anyone, or ALMOST bitten anyone? Please explain: *

My dog is dog friendly *

Yes

No

NO!!!

Unsure

My dog is current on vaccinations as recommended by my veterinarian, free of illness and parasites, and has not been exposed to any communicable illness within the last 30 days. Initial: *

Kennel cough and influenza vaccine are NOT required for grooming with us. If your dog receives these vaccines, please ensure that they are given a MINIMUM of 7 days prior to their appointment. Please see our website for additional information on this policy.

A credit card is required for all grooming reservations and a non-refundable deposit of $30 is required at the time of booking for all grooming appointments. 7 business days advance notice is required to cancel or reschedule a grooming appointment. If notice is given with less than 7 days a 20% fee will be charged. With less than 3 business days, the fee is 50%. No-shows will be charged for their entire appointment in full. *

I understand this policy and authorize Tails of Success to charge my card for the non-refundable deposit and any all cancellations fees accrued according to the above policy.

I recognize and accept the possible risks involved in participating in grooming and related services, including but not limited to cuts, scratches, scrapes, pulled or torn ligaments/tendons, communicable illness, escape and death. I accept full responsibility for any and all illness, injury and/or incident that might occur. I also accept full legal and financial responsibility for any damage or injury to persons, property or animals arising out of my dog’s participation in any service or other use of the facility. INITIAL: *

Thank you for choosing Tails of Success for your dog's grooming needs!

Please give us a call at 585-360-0030 to schedule your dog's Spa Services.

We ask that you bring a copy of current vaccine records to your appointment.