Bathing and Spa Services – Bullshead Pet Hospital

Current Clients : Please complete all form fields below and click submit to send your information to us. This form is for Current Clients Only.

New Clients please use our New Client Form

We will send you a return email to confirm your appointment. If we cannot confirm your appointment as requested, we will advise you either by return email or phone call.

If you need an appointment for today or tomorrow (Emergency/Urgent care within 48 hours), then do not use this form. Instead, please call us at (203) 324-5711 and Press 1 to speak with a CSR in order to schedule an Emergency/Urgent care appointment within those 48 hours. Bath or spa services appointments are not confirmed until you receive a reply from us.

Your Information

Owner’s Name

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Emergency contact phone

Pet Information

Pet Name

Breed

Species

If Other Species (please specify)

If your pet is not feeling well please provide a brief history

Appointment

Date

Note: Your appointment is not confirmed until you hear from us

Time

Services requested

Authorizations

I authorize a bath, pedicure and brush out of my pet(s) *

Yes

An additional brush out fee of $10-$40 may apply based on your pet’s coat condition.

I have read the DISCLAIMER below and agree to its terms. *

Yes

Signature *

I accept

By selecting “I Accept” using any device, means or action, you consent to the legally binding terms and conditions of this Agreement and the Disclaimer. You further agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing.

Type Your Name to E-Sign: *

Captcha *

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FORMS

New Clients

Current Clients