Grooming Consent Form – Chester Valley Veterinary Hospital

Owner's Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Pet's Name *

Do you think it is possible that your pet will bite or injure you while in the vet clinic? Please let us know so we can have staff prepared to help. *

Yes
No

Do you feel that your pet may bite or injure a staff member while at the vet? Please let us know so that we can keep all staff and animals safe. *

Yes
No

Do you have any physical limitations that would cause you to be unable to handle your pet inside the clinic? Please let us know so we can have staff prepared to help. *

Yes
No

If your pet is aggressive or reactive to people and/or other animals please keep them in your vehicle until you have checked in and your technician is ready to bring you and your pet directly into an exam room.

I am the owner of the animal named above, and have the authority to execute this consent and give Chester Valley Veterinary Hospital permission to bathe and groom my animal. *

I have read and authorize

The fees associated with these services have been explained to me, and I agree to pay such fees at the time these services are completed. *

I have read and agree

I understand, if not agreed upon before hand, that if sedation is needed Chester Valley Veterinary Hospital will attempt to contact me with an estimate before proceeding. If they are unable to reach me that they will not proceed with grooming. *

I have read and understand

I understand that my pet must be up to date on their rabies vaccination before grooming and that a vaccination exam will be charged for any animals requiring a vaccine during their grooming appointment. *

I have read and understand

I realize that grooming can require the use of scissors and other cutting instruments, and that the use of such can result in injury if the animal being groomed moves suddenly. In such an event I will not hold the groomer or Chester Valley Veterinary Hospital responsible for any injuries that occur during grooming. *

I have read, understand, and agree

I am aware that if my pet has a matt or multiple matts that cannot be brushed out, it/they will be cut out or shaved out as needed. This may result in an uneven look or bald spots and I will not hold the groomer or Chester Valley Veterinary Hospital responsible. *

I have read, understand, and agree

Signature *

Clear Signature

Date *