Agreement Form

Complete this form to finalize your appointment

Complete this form to finalize your appointment booking.

Your Information

First Name * Required

Last Name * Required

Email * Invalid email

Phone * Required

Pet Information

Pet's Name * Required

Pet Type * Required

Medical Conditions or Allergies (Optional)

Emergency Contact

Contact Name * Required

Contact Phone * Required

Agreement & Consent

I authorize Pawsome Smile to perform anesthesia-free dental cleaning on my pet. I understand that this service does not require sedation or anesthesia, and my pet will be handled with care and professionalism.

You must agree to this consent

I understand that Pawsome Smile will take every precaution to ensure my pet's safety and comfort. However, I acknowledge that there are inherent risks with any pet care service, and I release Pawsome Smile from any liability for injury or complications that may arise during or after the service.

You must agree to this consent

I consent to Pawsome Smile taking before and after photos of my pet's teeth for documentation and potential marketing purposes. (Optional)

I agree to receive appointment reminders and pet dental care tips from Pawsome Smile via email or SMS. (Optional)

Signature

Full Name (Electronic Signature) * Please provide your signature By typing your name, you are providing your electronic signature and agreeing to all terms stated above.

Date * Please select the date

Electronic Signature

Sign Below *

Please provide your signature Sign with your mouse or finger

Printed Name * Required

Date * Required

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Agreement Form

Your Information

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Agreement & Consent

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Electronic Signature

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