We want to get to know you!Please take a moment to fill out our new client form. New Client Registration Form New Client Registration Form YOUR INFORMATION Your Name * First Name Last Name Phone Number * (###) ### #### Email * Do you want to receive appointment reminders, updates and other correspondence via text and/or email? * Please choose 1 option Yes (text & email) Text Only Email Only No, please call only Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Alternate Contact First Name Last Name Alternate Phone Number (###) ### #### YOUR PET'S INFORMATION Your Pet's Name * Breed * Male (Neutered) Male (Intact) Female (Spayed) Female (Intact) Birth Date (if known) MM DD YYYY If birth date is unknown, approximately how old is your pet? * Weight * under 5 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 over 150 Who is your pet's regular veterinarian? Is your pet up to date with his or her vaccinations? Yes No I'm Not Sure Does your pet receive preventative treatment for fleas, ticks, intestinal parasites, etc.? Yes No Tell me a little about your pet (ie. temperament, allergies, health conditions, past grooming experience, etc.) How long ago was your pet's last grooming? less than 4 weeks 4 - 8 weeks over 8 weeks Never Unknown Can we give your pet treats? Yes No Hypoallergenic only May we post photos/videos of your pet to social media? Yes No How did you hear about The Tidy Paw Spa? Website Facebook Instagram Friend Other If referred by a friend or if other, please specify: Thank you for choosing our services and taking the time to fill out our form!
