Thank you for scheduling your Boarding & Grooming with us online! 
                        Simply fill out the following form and we will e-mail back to you a confirmation.    
                           Note: Sending a boarding request does not guarantee a reservation.

Owner's Information                         

 *E-mail  Address:

 * Owner's Name

   *Address: 

  *City: 

  *State:  

  *Zip Code: 

  *Home Phone#: 

  Work Phone#:

  *Cell Phone#:

Emergency Contact's Name:

 Phone #

 Name of your Veterinarian or Clinic?

 Veterinarian's phone #




  Dog #1's Information                               

 Dog's Name:                                                                                                           

 Gender:                                                                                                             

 Spayed or Neutered?                                                                                                  

 Breed(s):                                                       

 Age:   

 Color: 

 Gets along with other dogs?  
 Tells us more.                                              
 .                                          





Dog #1's Diet

 Type of Food :                            

 Brand of Food: 




 Additional Diet Information:




 Dog #1's Medication:                                                            

 Does your dog take medication?                                            

 Reason for Medication/s: 




 Name of Medication/s : 




 Dosage of Medication/s:  




 Additional Medication Information:




 Grooming Information
    
 Would you like your dog to be groomed?   

 Check all that apply:

 Bath/Brush (includes bath, blow dry, nails and anal glands):  

  Clip?   

 Type of cut? If  your not sure, the groomer can suggest a clip that would be best for your dog.




 Nails Only   $10

 Teeth Brushing  $10 



Dog #2's Information                                                                  

 Dog's Name:                                                                                                           

 Gender:                                                                                                             

 Spayed or Neutered? 

Breed/s


 Age:   

 Color: 

 Gets along with other dogs?  
 Tells us more.                                              
 .                                          





Dog #2's Diet

 Type of Food :                                                              


 Brand of Food:




 Additional Diet Information:




 Dog #2's Medication:                                                            

 Does your dog take medication?                                            

 Reason for Medication/s: 




 Name of Medication/s : 




 Dosage of Medication/s:  




 Additional Medication Information:




 Grooming Information
    
 Would you like your dog to be groomed?   

 Check all that apply:

 Bath/Brush (includes bath, blow dry, nails and anal glands):  

  Clip?   

 Type of cut? If  your not sure, the groomer can suggest a clip that would be best for your dog.



  Nails Only  $10

 Teeth Brushing  $10 


*required information
*Return Client?                                                             

*How many dogs will be staying with us?

*Arrival date?
                                       
*Time of drop-off ?

*Tentative pick-up date? 
                           
*Time of pick-up?

*Will we be grooming your dog/s?
   
  
 (661) 822-5800  Fax: (855) 822-0066
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malefemale
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yesno
yesno
yes
MaleFemale
yesno
yesno
yesno
yes
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yes
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yes