Name *

First Name

Last Name

Best Number to Reach You *

(###)

###

####

What Kind of Appointment Do You Need? *

Grooming Appts Friday/Saturday Sunday Only . Please Note Last Grooming Appointment Call Time is 4.15pm

Attended Dog Wash Only

Dog Groomer

Cat Groomer

Dog Dental Cleaning

Is This Your First Appointment With Mia's Bathhouse? *

Yes

No

Do You Have Proof of Up to Date Vaccinations? *

Yes

No

How Quickly Do You Need An Appointment? *

ASAP

Within 2 Weeks

Within 30 Days

Do You Have a Special Service Request? *

Not at this time!

Intensive Doggy Dental Treatment (No Anesthesia)

Hand Stripping (Groomer Hand Picks Dead Hair From Dog's Coat)