At-Risk Pet Release Form

Please review the information below and complete this form before your pet’s grooming appointment.

Reason for At-Risk Status

Due to one or more of the following reasons, your cat has been determined to have a higher risk of injury or health complications than the average pet.

Matting or pelting Old age Health concerns All three

Release Terms

Even gentle grooming can cause stress because the animal is outside its normal home environment. Because of the reasons selected above, I agree to the following as the owner or authorized representative of the cat:

Any grooming performed on an elderly cat or a cat with health problems carries increased risk. Grooming may expose pre-existing health or skin conditions. Elderly cats and cats with fragile skin may also have an increased risk of nicks, cuts, irritation, or sensitivity during shaving.
Dematting or detangling matted hair may cause patchiness, coat damage, or hair loss. I understand that shaving will significantly change my cat’s appearance and leave the coat very close to the skin. Mat removal may expose pre-existing skin conditions and may be stressful to the cat. Severe matting or pelting may result in an additional charge based on severity and grooming time. A fecal-removal surcharge or special-handling surcharge may also apply.
Certain illnesses and conditions, including diabetes, heart murmurs, hypertrophic cardiomyopathy, seizures, obesity, breathing problems, and other medical concerns, may increase the risk of an incident during grooming.
Previously discussed grooming styles, including a lion cut or comb cut, may not be completed when the cat’s health, behavior, stress level, or safety makes the requested style unsuitable. Chilltown Pet Spa may complete a different or limited service in the cat’s best interest. The client remains responsible for payment for services completed.
In the event of an injury or health concern, Chilltown Pet Spa is authorized to contact a veterinarian and request veterinary treatment when reasonably necessary. Chilltown Pet Spa will attempt to contact the owner using the emergency contact number provided below. The owner may be responsible for veterinary charges, depending on the circumstances and applicable law.

I have read and agree to all five statements above as the owner or authorized representative of the cat.

Client and Pet Information

Pet’s name

Owner’s full name

Date

Emergency contact number

Veterinarian or veterinary hospital

Veterinarian phone number

Owner signature

Signature date

By continuing, I acknowledge the Privacy Policy and Terms of Service.

This page is designed to be printed and signed by hand.