Head to Tail New Client Form

Ph 843.225.4500 Fax 843.225.4577
[email protected]
*Items in red are required info
Client Information
Primary Owner: _______________________________________ Cell Phone: _______________________________
Spouse / Other: _______________________________________ Cell Phone: _______________________________
Address: _______________________________________________________________________________________
Home Phone: ________________________________________ Other Phone: ______________________________
Primary Email: __________________________________________________________________________________
Other Email: ____________________________________________________________________________________
Emergency Contact Name & Number: ______________________________________________________________
***The emerency contact should be a local/nearby resident to call if the owners are unavailable***
How did you hear about us? ______________________________________________________________________
Vet Information
Primary Vet Clinic: _______________________________________________________________________________
City, State & Phone: __________________________________________________________________________________
***Please provide copies of current vaccination records, or have your vet fax them to us***
Pet Information
Pet #1:
Pet #2:
Name:
Breed:
Color:
Weight:
Gender:
Fixed:
Date of Birth:
Employee Notes: Employee Use Only
Rabies:
Bordatella:
Distemper:
Employee Use Only
Rabies:
Bordatella:
Distemper:
Please read and sign the back ----->
Pet Information
Pet #3:
Pet #4:
Name:
Breed:
Color:
Weight:
Gender:
Fixed:
Date of Birth:
Employee Notes: Employee Use Only
Rabies:
Bordatella:
Distemper:
Employee Use Only
Rabies:
Bordatella:
Distemper:
General Services & Grooming Agreement
Head to Tail Day Spa & Inn, LLC (referred to as Head to Tail LLC hereafter) agrees to provide services in a reliable and trustworthy
manner. In consideration of these services and as an express condition thereof, the client agrees to waive any and all claims against
Head to Tail LLC unless arising from negligence on the part of Head to Tail LLC.
Client represents dog as being in good health, currently vaccinated and free of any communicable diseases.
Client represents dog as non-aggressive. Client agrees dog has not harmed another animal, person or thing and has not shown any
aggressive behavior. Client understands any harm caused by dog to another person, animal or property is the responsibility of the
client.
Head to Tail LLC does its best to be as careful as possible. There may be times when a dog is slightly injured due to sudden
movements. Client understands and accepts these risks and will be notified of any incidents resulting in minor injury. In the event of
a serious injury, and after all necessary attempts to reach the client fails, client authorizes Head to Tail LLC to seek medical attention
at the client's vet clinic, Head to Tail's primary vet clinic (Ohlandt Veterinary Clinic) or at the nearest emergency vet clinic
(Charleston Veterinary Referral Center).
In the event the dog shows aggressive behavior and Head to Tail LLC cannot complete the job for fear of injury; client agrees to
remain responsible for all applicable charges whether work is completed or not. If we cannot begin work, we will return dog to you
with no charge.
Client allows Head to Tail LLC to photograph or video their pets while in our care. These photos/videos may be used for marketing
purposes.
This agreement will remain valid for all future services.
By signing below the client fully understands and agrees to the contents of this waiver and gives Head to Tail LLC the right to
perform duties as described by client.
Client Signature
Date