Dog Release Form

Policies & client information  

Client’s Last Name ___________________________First Name________________ 

Address _________________________________________________

Phone _________________ Cell____________________ Email ___________________________________________________ 

Person(s) authorized to pick up my pet __________________ __________________________________________________________ 

How did you hear about us? _____________________________ 

Emergency contact name _______________________________ 

Emergency contact phone _______________________________


Breed _____________________________ Sex _____ Age ________ 

Vet _______________________________________________________ 

Vet number___________________________

dates of last shots______________________Bordetalla______________ Flea treatment______________

Does your dog have any known medical issues? __________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ 

Is your pet taking any medications? ______________________ ___________________________________________________________

To help us decide if your dog needs special care please answer the following in Yes or No

Dog agression___________ Kid Friendly___________ Biter_____________ Cage agression___________ escaper_________

climber/fence jumper___________ eats leash____________ Barker______________ Sensitive to touch___________ Sensitive to sounds___________

chronic ear infectons____________ anal gland issues____________ Skin allergies_____________

Anything your previous groomer had issues with?__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

1. What is your preferred method of contact for appointment reminders? (please check one) ___Phone call ___Text message ___Email

2. Occasionally we post photos of some of our favorite pets. Do we have your permission to post photos of your pet on our website and/or social media pages?  (please check one) ___Yes ___No

Steampup Parlor philosophy is to offer a stress-free quiet grooming experience for your loved dog. We pay special attention to older dogs and dogs with health issues. Your dog’s safety and comfort are our first priorities. We will not perform any grooming procedure that causes pain or a level of stress that we think is excessive. This includes nail trimming in some situations. Senior dogs will be groomed for cleanliness and comfort.

MEDICAL / VACCINATIONS: You the pet owner will advise us of any medical, physical, emotional issues, allergies, sensitivities or pre-existing conditions. These may include prior surgeries, hip or joint issues, warts, moles, ear infections or skin problems. Steampup Parlor requires your dog to have its current rabies vaccination for every pet being groomed. While Steampup Parlor adheres to a stringent sanitation procedure for all our equipment, we also strongly advise that each dog be vaccinated against distemper, hepatitis, parainfluenza adenovirus type 2, parvovirus, corona, leptospirosis, and Bordetella prior to being groomed.

BEHAVIORAL CHALLENGES: Steampup Parlor has the right to refuse grooming any dog that may be a threat to itself or any person. If we are not able to get a muzzle on a dog that may bite, then we may have to refuse it for its own protection and ours. If your dog cannot be finished groomed for any reason any accord groom fee will apply. The dog owner will be held responsible for any bites that may require medical treatment and for any property damage caused by their dog. All bites will be reported to the local authorities as required by law. Steampup Parlor does not administer tranquilizers, nor do we groom dogs that are sedated. We recommend talking to your vet about CBD oil which we will attempt to groom your dog under this type treatment only.

POTTY/FOOD: Please walk your dog prior to appointment to relieve themselves, we do not potty break dogs here at Steampup Parlor and any dogs that are fearful please do not feed dogs prior to appointment and feed them when they go home. We provide short stays so its unnecessary for them to be feed them within 2-3 hours prior the appointment. Please reschedule your appointment if you notice any soft stools prior appointment or any sudden health changes.


Steampup Parlor 

1405 String Street #102 

Phone: (805) 712-2443 


Steampup Parlor Authorization for

Shaving a Dog, Barking Dogs, Flea & Tick Treatment and/or Drop off/Pick Up

SHAVING DOGS: We do not recommend shaving double coated breeds, but sometimes it's necessary to start coat over from a pelted mat. Shaving a dog often exposes pre-existing skin conditions. If an animal is badly matted, you may find sores and tender skin under those mats. Many times, the skin is so sore that the clippers may cut the skin, especially while taking mats off.

FLEA FREE ZONE: We also are a Flea & Bug Free Zone. So all dogs must be on flea prevention at our parlor. If we see any we use all natural and solutions and procedures to treat your dog for fleas and ticks. Some animals are sensitive to these solutions and procedures and may experience an allergic or other reaction that could be serious. You will be notified immediately and will require prevention before next visit and a fee will be applied. 

BARKING DOGS: We are a quiet salon so if your dog is a barker please notify us before hand these dogs MUST be booked at 8:30 and picked up by 10am before other tenants open in our building. Any excessive screamers may be refused and require immediate pick up. MATTING: If your pet cannot be humanely de-matted, we may ask permission to clip the hair short and start over. Please keep in mind that a matted coat can cause numerous health concerns including itching, irritation, and skin infections. Removing a heavily matted coat includes risks of nicks, cuts or abrasions due to warts, molds and skin folds trapped and hidden in the mats. Heavy matting can also trap moisture near the pet’s skin allowing fungus or bacteria to grow causing skin irritations that exist prior to the grooming process. Steampup Parlor is not responsible for any preexisting conditions due to a matted coat. If you would like to reschedule your grooming appointment to allow time to brush or comb out the excess matting, a $25.00 minimum groom fee will apply.

DROP OFF/PICK UP: We are a appointment only and short stay parlor. All appointments are done under a few hours and require immediate pick up when dog is finished. Unless your dog is having a service that requires several hours to complete we expect dog to be promptly picked up upon call or text by groomer. A $25 fee is applied 15 minutes after you’re appointment and is considered a “No Show” and cancelled. Payment must be paid before next appointment.  Dog’s not picked up with in 30 min. of call or tex will be charged $25 boarding fee. Any dogs picked up after Closing hours will be charged $1 per minute til they are picked up which we have the right to refuse future services to client. 

RELEASE I am the owner/caregiver of this/these dog(s), and I have read and understood the foregoing cautions, printed above. I realize that dog grooming may cause injury or allergic or other reaction to my dog(s), but I desire to have Steampup Parlor perform the grooming. Therefore, I consent to and authorize the grooming of my dog(s) and I release Steampup Parlor and its staff, or other representatives, from any responsibility or liability arising out of the performance of those services. I have read and accept this release for the groom today and for all future grooming appointments. I have read and understand the above policies.


Signature_________________________________________ Date________________

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