Client Intake Form - KOA and CO

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Pet Information

Owner Full Name

Phone Number

Email Address

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Pet Name

Breed

Color/Markings

Date of Birth / Age

Date

Time

Gender

Approximate Weight

Veterinarian Name

Veterinarian Phone

Is your pet up to date on vaccinations?

Any allergies or medical conditions?

Current medications

Health & Medical Conditions: I certify that my pet is in good health and has not shown signs of illness. I understand grooming may expose hidden medical conditions or aggravate existing ones.
Vaccinations: I confirm my pet is current on required vaccinations and free of contagious conditions.
Matting Policy: Severely matted coats may require shaving. I understand this can cause skin irritation or minor nicks and I consent to necessary coat removal for my pet’s comfort and safety.
Behavioral Issues: I agree to inform the groomer of any biting, aggression, anxiety, or sensitivities. If my pet becomes aggressive, services may be stopped for safety.
Accidents: While every precaution is taken, grooming tools are sharp. I understand minor cuts or abrasions can occur.
Emergency Care: In the event of an emergency, I authorize KOA & Co Dog Grooming Spa to seek veterinary care. I agree to be financially responsible for related costs.

Photo Release (Optional)

I allow
I do not allow photos of my pet to be used for social media or marketing purposes.

Owner Signature

Printed Name

Date