Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code If you live on Ft. Moore, formerly Ft. Benning, please list your housing area in the text box below.Email*Home PhoneCell Phone*Pet InformationVeterinarian Name/ Clinic*Veterinarian Phone NumberMay I use a photo of your pet on Personal Paws' website and Facebook Page?* Yes No Pet Information*Click the plus sign to add more petsPet NameBreedAgeWeight Class (see below)Medical ConcernsDate of last professional groomType of Service Weight Classes A) 0-10lbs B) 11-20lbs C) 21-40lbs D) 41-60lbs E) 60-100lbs * WE DO NOT ACCEPT PETS 100 LBS AND ABOVE Terms of Service Personal Paws, LLCPets are accepted for grooming only under the following: The Pet is fit and healthy. Grooming an elderly or unhealthy pet will be at owner's risk. Grooming may expose pre-existing health/ skin problems for which the company cannot be held liable. The pet's rabies vaccine is up to date (as required by law) if age appropriate. In the event of an emergency, in my absence, I authorize Personal Paws LLC to contact a Veterinarian and authorize the Vet to treat the pet as necessary at my expense. Payment is to be made at the time of service. Payment can be cash, credit/ debit card, Paypal, Venmo, or Zelle. Any cancellation made less than 24 hours before your service will result in a cancellation fee of $65. Nail cutting and ear cleaning are part of the service unless the process is too stressful for the pet or too dangerous for the groomer. "De-matting" or complete coat removal can cause skin irritations or expose pre-existing skin conditions. It will dramatically alter your pet's appearance. This procedure may expose pre-existing health/ skin problems for which the company cannot be held liable. We reserve the right to refuse service is the pet is dangerous to himself or the groomer. Appointment times have a half hour window. The pet must be initially available from 30 minutes before to 30 minutes after the scheduled time. Consent* I hereby agree to all above listed TERMS OF SERVICE*Signature*Date* MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.