Avondale Grooming Salon - Dog Grooming Request

DOG GROOMING REQUEST FORM

*One of our staff members will contact you by phone
to respond to your groom request,
or feel free to call us at 515-262-0017.

**Please submit a separate form for each pet.

Today's Date

Date groom is being requested

Owner Name

Spouse/Other

Are you currently a grooming client at Avondale?

Yes

No

Home Address

City, State and Zip

Home Phone

E-mail Address

Employer

Work Phone

Cell Phone

Spouse/Other Cell Phone

Spouse/Other Employer

Work Phone

E-mail Address

Name and Phone Number of Emergency Contact

Name of your pet's Veterinarian/Clinic

How did you become aware of Avondale Grooming?

If you learned about our service from a personal recommendation, whom may we thank?

Pet's Name

Pet's Date of Birth or Age

Sex

Male	Female
Neutered	Spayed

Breed

Color/Markings

Pet's Vocabulary (nicknames, phrases and commands he/she responds to: Have to go potty?)

Pet's responses to physical contact (favorite places to be scratched, touched or places NOT to touch)

Other tips or handling suggestions

Any allergies or prior illnesses of which we should be aware?

Type of groom desired

For breed cut, please specify breed

Other services

If other services are desired, please specify

Do you have Pet Insurance?

Yes

No

If yes, with which company?

Groom drop-off times are:
Monday - Friday: 7:00 am - 9:00 am
Saturday: 8:00 am - 9:00 am
Sunday: 10:00 am - 11:00 am

If you need to drop off at times other than this, please call 515-262-0017 and talk directly
with a Pet Resort/Grooming Representative about your specific request.

*****All animals must be current on all their vaccines to be in the grooming salon and
a negative stool sample should be less than 6 months old.

Looking forward to being of service to you and your pet!
Avondale Grooming Salon

When you have finished completing the information,
please press SUBMIT.

* Indicates Response Required

Hospital Sign	Yellow Pages	Website
Facebook	Commercial	Other

FURminator	Bath & Brush
Spa treatment	Shave down
Dematting	Breed cut, specify breed below

Brush teeth	Playtime while here	Doggie Daycare while here
Paint Toenails	Tick Removal	Dry skin treatment
Medicated Bath	Vaccines	Heartworm Check
Fecal Examination	Other - please specify below