GROOMERS' RELEASE FORM
The following is the release form I have
all customers sign. It is on a 5"X 8" card with a record grid on
back. Please feel free to substitute your business' name and use if you like
it; I ask only that you email me
and let me know of your intentions. Please enter "Release Form" as
subject and include your name/state in the body.
Kat's Pups 'n' Pals
2100 Lapalco Blvd.
Harvey, LA 70058
Owner's
Name:_____________________________________
Pet's Name:______________________________
Address:______________________________________________________
Breed:_______________________
Phone#
(h)_______________(wk)_______________Emergency#_______________
Veterinarian:_______________________________________
Medical Problems?__________________________
Diet
(boarding only):_____________________Special
Instructions:___________________________
_________________________________________________________________________________________________
--PLEASE READ CAREFULLY AND SIGN BELOW--
If
pet is hurt or becomes ill, Kat's Pups 'n' Pals (KP&P) has permission to
call or take pet to veterinarian of our choice if pet's vet is inaccessible;
or administer medication; or give other advisable attention, with our
discretion and judgement, and such expenses will be paid promptly by owner
unless injury is direct result of negligence of
KP&P. We will not be
held responsible for any sickness or injury caused by the pet to itself during
grooming or boarding.
KP&P
is not responsible for any accidental death of pet of the nature of
pre-existing health condition or natural disasters (fire, storm, flood, etc.).
KP&P
will not be held responsible for clipperburn and/or minor nicks resulting from
grooming of matted, neglected coats or for irritation caused by removing coat
from pets possessing mild to severe skin allergy,
nor will we be held responsible for stressful effects grooming may have
upon an elderly pet.
KP&P
will be notified of any claims by owner regarding compensation for medical
attention given as a result of alleged negligence on our part within 48 hours.
In the event we dispute owner's claim, we will personally consult the
attending veterinarian prior to settling any claim.
We
reserve the right to charge additional fees for services we consider over and
above the norm covered by our standard rates.
We also reserve the right to refuse service to customers whose pet may
pose a threat to us or to the other pets left in our care, whether it be an
aggression problem, health problem, or parasite problems (other than fleas).
Owner
agrees to be responsible for any property damages by pet.
If
a grooming client is not picked up by closing time _______PM, the pet will be
boarded at the rate of $______/night
until released to owner. If the
pet is not called for within fifteen (15) days of stated time of return, KP&P
has the right to dispose of pet as we see fit (in most cases, placement in a
suitable home) within ten (10) days after this period.
The owner will receive one (1) notification by registered mail during
this period...no further notice will be given.
We
are here to serve you and your pet to the best of our ability; if you have any
problems, please notify Kathleen Lyvers.
Signature:
__________________________________________________________
Date:______________
© Copyright 1997-2002 Kat
Lyvers