* Denotes Required Fields
First Name: *
Last Name: *
Street Address: *
City: *
State: *
Zip: *
Phone (Home): *
Phone (Work):
Phone (Cell):
Email: *
Alternate Email:
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone (Home):
Email:
Dog's Name: *
Sex: *FemaleMale
Breed: *
Birthday: *
Please provide veterinary records showing up to date: Rabies, Distemper or DHLPP, Parvo (if no DHLPP)Records may be attached to application or faxed directly from your Veterinarian’s office to 610.592.9230
Current Veterinarian: *
Veterinarian Phone:
Attach Veterinary Records:
I will fax vaccination records separately
Length: shavedtrim - Length left on dog in inches
Face: shavedroundsquare
Tail: shavedfannedball at the end
Teeth Brushing? ($5 extra) YesNo
Shampoo: Hypoallergenic (No dyes, no perfumes)Oatmeal (Gentle but scented)The oatmeal also includes a scented conditioner.
Frequency of Grooming: 6 weeks8 weeksotherIf Other:
Comments:
Please tell us how you heard of us: ReferralInternetNewspaperEventYellow PagesOther
If Other, Please explain:
If referred, please provide referrer:
Once application is and most recent vet records are received, we will contact you to schedule an evaluation appointment.
Please leave this field empty.
Monday thru Friday 6:45 AM to 7:00 PM
Saturday 8:00 AM to 6:00 PM
Sunday 9:00 AM to Noon (Boarding Pick-up & Drop-off Only)
Private Session Packages
Basic ObedienceThursday, 2/4 - 6:00 PM
Stay & Train
Beyond BasicThursday, 2/4 - 7:15 PM
View Full Schedule
Welcome to Cubby’s new website!
November 9, 2013
