Client Information Card
March 23, 2016
This is my client information card. Feel free to copy it, but, of course, change my information to yours.
Name_________________________________________________________________________________________
Address_______________________________________________________________________________________
Email_________________________________________________________________________________________
Home phone__________________________________________________________________________________
Cell Phone____________________________________________________________________________________
Preferred method of contact________________________________________________________________
Name Breed Age Medical Concerns
- ________________________________________________________________________________________
- ________________________________________________________________________________________
- ________________________________________________________________________________________
- ________________________________________________________________________________________
Can your pet have a treat? Yes No
In the event of a heart attack, I authorize Mary Oquendo of Pawsitively Pretty Mobile Grooming Salon LLC (circle one) to perform not perform CPR. I hold Mary Oquendo and Pawsitively Pretty Mobile Grooming Salon LLC harmless for these actions.
Signature and Date
In the event of a medical emergency and I can not be reached, I authorize Mary Oquendo and Pawsitively Pretty Mobile Grooming Salon LLC to bring my pet to the closest available veterinarian for treatment. I allow the veterinarian to treat my pet. I will be financially responsible unless Mary Oquendo and Pawsitively Pretty Mobile Grooming Salon LLC assume responsibility.
Signature and Date
In the event of inclement weather or natural disaster, Mary Oquendo and Pawsitively Pretty Mobile Grooming Salon LLC, is entrusted to use best judgment in caring for my pet and will not be held liable for consequences related to such decisions.
I also authorize Mary Oquendo and Pawsitively Pretty Mobile Grooming Salon LLC to assume guardianship over the following pets in my household until which time I can safely take possession of my pets.
_________________________________________________________________________________
Name and breed of other pets
Signature and Date
Veterinarian and Phone Number
Do you wish to be added to a quarterly newsletter that will have seasonal and safety tips as well as an invitation to a free webinar?
Yes No
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