New Customer Bathing Reservations

New Customer Bathing Reservation Form
Owner Details
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail*
Emergency Contact Name:
Emergency Contact Phone Number

Area CodePhone Number
Pet Details
Pet Name*
Pet Breed*
Pet B-date*
Color*
Vet Name:*
Vet Phone:
Sex*

MaleFemale
Altered*

Spayed (Female)Neutered (Male)Intact
Weight:*
Medication
Medication Dosage
Pet Food Brand:
Pet Food Amount
Comments
Vaccinations
You must bring a photocopy of the vaccination paperwork from your vet.
You may also have your vaccination
paperwork faxed to us at: 603-536-4219.

NO ANIMAL WILL BE ADMITTED WITHOUT PROPER VACCINATIONS.
Rabies Expiration*

MonthDayYear
Distemper Expiration*

MonthDayYear
Canine Cough Expiration*

MonthDayYear
Cats Only - Feline Leukemia Expiration

MonthDayYear
Titer Notes

Additional Pet? Click the arrow over there ----->
Pet Name #2
Pet Breed #2
Pet B-date #2
Color #2
Vet Name #2
Vet Phone Number #2

Area CodePhone Number
Altered #2

Spayed (Female)Neutered (Male)Intact
Sex #2

MaleFemale
Weight #2
Medications #2
Medication Dosages #2
Pet Food Brand #2
Pet Food Amount #2
Pet Comments #2
Vaccinations
You must bring a photocopy of the vaccination paperwork from your vet.
You may also have your vaccination
paperwork faxed to us at: 603-536-4219.

NO ANIMAL WILL BE ADMITTED WITHOUT PROPER VACCINATIONS.
Rabies Expiration

MonthDayYear
Distemper Expiration

MonthDayYear
Canine Cough Expiration

MonthDayYear
Cats Only - Feline Leukemia Expiration

MonthDayYear
Titer Notes:

New Customer Bathing Reservation Form