Lori’s Pet-Agree Grooming Salon

Pet Record Form

Name *

First

Last

Email *

Address *

City *

State *

Zip *

Phone (Home)

Phone (Work)

Phone (Cell)

Phone (Other)

Pet's Name

Breed and Color

Age

Sex

Neutered/Spayed

• Yes
• No

Date of Last Rabies Vaccine

Vet Clinic

Health Concerns

Groom Dislikes

Do you or your pet have allergies to perfumes or scented shampoo?

• Yes
• No

Does your pet chew leashes?

• Yes
• No

Other Comments

Submit