New Customer Form

Owners Full Name:*

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Mobile Number:*

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Email Address:*

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Emergency Contact Name and Number*

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Dogs Name:*

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Dogs Breed:*

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Date of Birth/Age:*

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Approximate Weight:*

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Health and Medical Info including Allergies*

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Please tell me about any nervousness, reactivity, bite history, handling sensitivities or previous grooming difficulties. Don't worry - this is a judgement free zone! The more I know the better :)*

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I confirm the information I've provided is accurate and will let Groomies know about any changes.*

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I have read and agree to Groomies At Salthouse's Terms and Conditions*

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I understand my dogs groom may be adapted or stopped if Ayla feels this is necessary for their welfare or safety.*

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Photo Permission - I'm happy for photos/videos of my dog to be used on Groomies' website and social media.

I hereby agree that this data will be stored and processed for the purpose of establishing contact. I am aware that I can revoke my consent at any time.*

* Indicates required fields

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