Pet's Name_____________________________________________________________
Owner's Name______________________________
 
Veterinarian _______________________________
In Case of emergency:  Location _______________
Friend or Relative  __________________________
In Date   __________________________________
Out Date__________________________________
 
 
 
 
Check here if you've put additional information on the back of this form _______
 
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Phone  _____________________
Cell Phone __________________
Phone  _____________________
Phone  _____________________
Phone  _____________________
Time  ______________________
Time  ______________________

Tax________________________
Total_______________________
Innkeeper Judy McCauley, Master Groomer
Route 3, Box 197, Philippi  WV  26416
(304) 457-BARK (2275) or (304) 457-1695


Board @_____________________________ Per Day X__________ Days = $
In Season ____ 
Before 8:00 am ____    After 6:00 pm____      
8:00 pm -- 8:00 am ____ (Extra Day Charge)
Saturday Drop Off ____                     Sunday Drop Off  ____
Saturday Pick Up ____                     Sunday Pick Up  ____
Major Holiday Drop Off ____     Major Holiday Pick Up  ____
Medication @_________________________ Per Day X__________ Days =
Grooming______________________________________________________
Flea Bath-Dip __________________________________________________
Nails Clipped and Filed___________________________________________
Teeth _________________________________________________________
Food__________________________________________________________
Shampoo______________________________________________________
Miscellaneous__________________________________________________
Training @____________________________ Per Day X _________ Days =
Pick Up and Delivery ___________________ Per Mile X _________ Miles =
                                                                                    SUBTOTAL $
                                                                                               TAX  $
                                                                                           TOTAL  $
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