Coulter Animal Hospital

5200 S. Coulter St
Amarillo, TX 79119

(806)353-6673

coulterah.com

Grooming Instructions Form

Name (required)
First Name (required)
Last Name (required)
Pet's Name (required)

Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Date :
Appointment :
Please Check all that apply:
Would like to have the same grooming as your pet's last visit?
Would you like the Groomer to decide how your pet will look?
Would you like your pet to have a Bath & Brush?
Explanation (please be descriptive)

Would you like your pet to have a Bath & Cut?
Explanation (please be descriptive) and select the length of hair (next question)

Length of hair wanted?
a. #3 = 3/4inch
b. #4 =3/8 inch
c. #5 =1/4 inch
d. #7=1/8 inch
Does your pet have mats in their hair?
Explanation (Please be descriptive)

Does your pet have any fleas or ticks?
Explanation (Please be descriptive)

Do you want your pet shaved?
Explanation (Please be descriptive)

Do you have any special concerns or requests?

Any other special instructions you have concerning your pet?

Does your pet have any allergies, abrasions, rashes, moles or any type of lesions? Please specify.


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CLINIC HOURS:

Monday - Friday

7:30 AM - 6:00 PM

Saturday

8:00 AM - 12:00 PM

(No grooming available)

Sunday

C L O S E D

(No boarding drop-off/pick-up)

EMERGENCY AFTER-HOURS CALL 806-353-6673 AND FOLLOW THE RECORDED PROMPTS

*

Appointments Preferred

    Call for Walk-In Policy     


ePet Health is a private website that gives you secure online access to your pet's health information. We provide this ePet Health site free of charge to all clients who have an active email address on file.