GROOMING
REGISTRATION
OWNER INFORMATION
Last name:
First name:
Address:
Apt/Suite:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Alt. Phone:
How did you hear about us?
Email Address:
EMERGENCY CONTACT
Your emergency contact must be able to make immediate
decisions based on your dog's health, in the event that we are
unable to contact you in case of an emergency.
Name:
Phone Number:
DOG INFORMATION
Name:
Breed:
Color(s):
Gender:
M
F
Weight:
Lbs.
Is your dog spayed/neutered?
Yes
No
Birthdate:
DOG #2 INFORMATION
Name:
Breed:
Color(s):
Gender:
M
F
Weight:
Lbs.
Is your dog spayed/neutered?
Yes
No
Birthdate:
DOG #3 INFORMATION
Name:
Breed:
Color(s):
Gender:
M
F
Weight:
Lbs.
Is your dog spayed/neutered?
Yes
No
Birthdate:
MEDICAL INFORMATION
Veterinarian/Clinic Name:
Address:
City:
Phone Number:
My Two Dogs Inc., in accordance with the City of New York, requires up to date vaccination records on all dogs who are
receiving services from our facility. This applies to both new and regular clients. It is your responsibility to make sure we
have your dog's current vaccination records before his/her appointment. If we do not have current records, your dog's
appointment will be rescheduled. Records can be faxed or emailed to us from your vet.

I have read and understand the above statements regarding vaccinations at My Two Dogs Inc., and am the primary
owner of this dog.
Please type your initials here:
Please tell us about any pre-existing
medical issues that your dog has:
Please tell us anything else you would
like us to know about your dog(s):
*You will be asked to sign a standard grooming contract before your dog's first grooming session.