New Clients

Thanks for filling out this form, it will help us better understand you and your pet's needs.

*(denotes required field)

Name: *

E-Mail Address: *

Spouse or Significant Other's Name:

Street Address:

City, State, Zip (eg: Wilmington, NC, 28401):

Home Telephone Number:

Mobile Cell Phone Number: *

Work Telephone Number:

Alternate Telephone Number: *

Emergency Contact (eg: "John Smith"): *

Emergency Contact Number:

Pet 1

Pet Name:

Breed:

Color:

Gender:

Spayed/Neutered:

Yes
No

Clinic Name:

If your vet is not listed, please select "NO LOCAL CLINIC" and fill in the information below.

Clinic Name:

Clinic Address (eg: 123 Doggie Way):

Clinic City:

Clinic State:

Clinic Zip:

Clinic Telephone:

Pet's Birthday:

Pet Weight:

Pet 2

Pet Name:

Breed:

Color:

Gender:

Spayed/Neutered:

Yes
No

Clinic Name:

If your vet is not listed, please select "NO LOCAL CLINIC" and fill in the information below.

Clinic Name:

Clinic Address (eg: 123 Doggie Way):

Clinic City:

Clinic State:

Clinic Zip:

Clinic Telephone:

Pet's Birthday:

Pet Weight:

Pet 3

Pet Name:

Breed:

Color:

Gender:

Spayed/Neutered:

Yes
No

Clinic Name:

If your vet is not listed, please select "NO LOCAL VET" and fill in the information below.

Clinic Name:

Clinic Address (eg: 123 Doggie Way):

Clinic City:

Clinic State:

Clinic Zip:

Clinic Telephone:

Pet's Birthday:

Pet Weight:

Pet 4

Pet Name:

Breed:

Color:

Gender:

Spayed/Neutered:

Yes
No

Clinic Name:

If your vet is not listed, please select "NO LOCAL CLINIC" and fill in the information below.

Clinic Name:

Clinic Address (eg: 123 Doggie Way):

Clinic City:

Clinic State:

Clinic Zip:

Clinic Telephone:

Pet's Birthday:

Pet's Weight:

New Clients

Pet 1

Pet 2

Pet 3

Pet 4

Location

Featured Services

Medicated Shampoo and 10 Minute Soak (Med-Long Hair) $10.00

Color-fur Extensions (Both Ears) $15.00

Obedience Training

Better Business Bureau Rating

On Facebook

Quicklinks