Grooming Consent Form Owner's Name:*Contact Number:*Late Pick-Up* : HH MM AM PM Pet's Name:*Breed:*Health Conditions:*Treats OK?*YesNoGrooming Services* Bath Basic (NO HAIRCUT, AT ALL) Other (Be very Specific) **All Grooms Include Ear Cleaning, Nail Trim, & Anal Gland Expression** **Matted or Difficult Pets Will Incur Additional Fees Starting at $10** **Groomers are not responsible for injuries on these types of pets.**ADD-ON SERVICES WITH PURCHASE OF A GROOM Furminator $20-$35 Medicated Bath $5-$15 Prescription Shampoo $8-$15-$20 Conditioning Treatment $5-$15 whitening Shampoo $5-$15 Tooth Brushing $5 Nail Filling $10-$15 Blueberry Facial $5 Flea Bath $10-$15 Oatmeal Bath $5-$15 Application Fee for Owner's Product Quantity of bottles:*$4 per bottleVeterinary ServicesCanine Vaccine Clinic $135.10 Rabies DH2PPC Bordetella Nasal Fecal Heartworm & TickBone Illness Test Heartworm Prevention Feline Vaccine Clinic $95.10 Rabies FVRCP Fecal DOCTOR PLEASE CHECK MY PET'S*I authorize Hurstbourne Animal Hospital to use all reasonable precaution against injury,escape, or death of pet. The Hospital and staff will not be held liable any problems that develop,provided reasonable care and precaution are followed. I understand that any problems that develop with my pet will be treated as needed, and I assume full financial responsibility for the treatment and expenses incurred.WE ARE NOT RESPONSIBLE FOR COLLARS OR LEASHESDate* Owner/Agent*
