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EASTON LOCATION
(610) 829-5757
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ALLENTOWN LOCATION
(610) 366-8282
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Allentown Consultation Form: Board & Train
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Easton Daycare and Boarding Enrollment Form
Easton Grooming Enrollment Form
Easton Training Enrollment Form
Easton Consultation Form: Board & Train
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STOP IN TODAY ➤ 6346 FARM BUREAU ROAD ALLENTOWN, PA 18106
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Grooming Enrollment Form
Grooming Enrollment Form
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- General Owner Information
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Last Name
Address
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Primary Contact Name:
*
Primary Contact Phone Number:
*
Please enter the cell phone number that you wish to receive important calls, text message reminders and appointment confirmations at.
Leader of the Pack Canine Institute Privacy Policy Agreement
*
I agree to the privacy policy.
Leader of the Pack Canine Institute, LLC maintains strict privacy policies to protect the personal information of our users obtained for text message communications. This information is never sold, rented, released, or traded to others without prior consent or legal obligation. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. Any sharing of information with third parties is solely for the purpose of fulfilling the organization's obligations to the user.
By submitting your phone number, you are authorizing us to send you text messages and notifications. Message/data rates apply. If you are receiving text messages from us and wish to stop receiving them, simply respond with STOP to the number from which you received the message. Once we receive your message, you will no longer receive further text messages from us unless opting back in by replying again with SUBSCRIBE.
Secondary Contact Name:
Secondary Contact Phone Number:
Email
*
Emergency Contact(s) (Not in Same Household)
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Name
Phone
Relationship
Approved Person(s) for Pick Ups/Drop Offs: (Not in Same Household)
Name
Phone
Relationship
Dog’s Name
*
Dog's Breed
*
Dog's Color
*
Dog's Weight
*
Dog's Gender
*
Choose Gender
Male
Female
Dog's Birth Date
*
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Fixed (Neutered/Spayed)
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Yes
No
Fixing (Spaying/Neutering) Appointment Date
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Veterinary Clinic
*
Referral
*
How did you hear about Leader of the Pack?
Friend / Family referral
Vet Office
Internet Search
Radio Advertisment
Newspapers
Facebook
Sign
Magazine
Bill board
Other
Please describe how you heard about us.
*
Dog License
Number
County
Microchip
Microchip Number
Brand
Has your dog ever been groomed before?
*
Yes
No
Is your dog comfortable being in a crate?
*
Yes
No
How does your dog react to other dogs?
*
Happy to see them
Go away I don’t like you
Indifferent to them
Does your dog have any medical/health issues we need to be aware of? (i.e. seizures, heart/hip problems etc.)
*
Yes
No
Is so, please explain:
Does your dog have any allergies to foods, shampoo, or cologne?
*
Yes
No
If so, please list:
Has your dog ever had an issue with getting groomed or handled by a person outside of your family?
*
Yes
No
If so, please explain:
Has your dog ever had any previous negative grooming experiences?
*
Yes
No
If so, please explain:
Is your dog comfortable with having his/her feet touched for nails?
*
Yes
No
Does your dog require any medication for grooming?
*
Yes
No
If so, please list and explain:
Describe any behavioral problems/idiosyncrasies/special sensitivities we should be aware of
*
IF ANY OF THE ABOVE INFORMATION CHANGES, PLEASE NOTIFY US IMMEDIATELY!
Grooming Rules and Regulations
*
I Have Read The Rules And Regulations
Grooming Client Aggreement
*
I Have The Client Agreement
Grooming Waiver and Release Form
*
I Have Read The Waiver and Release
Signature (Signee acknowledges all forms have been read and agreed upon, Signee be at least 18 years of age)
*
Upload vaccination records below:
Drop files here or
Select files
Max. file size: 64 MB, Max. files: 10.
Upload your dog's picture below:
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Select files
Max. file size: 64 MB, Max. files: 10.
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If you wish to print and scan the enrollment form instead, you can access the PDF versions here:
Grooming Enrollment Form
Grooming Rules & Regulations Form
Grooming Client Agreement Form
Grooming Waiver and Release Form