[vc_column width=”1/4″][vc_column width=”1/2″] Form Test Page Dog’s Name(Required)BirthdayAgeVeterinarian(Required)Vet’s Phone(Required)Owner's Name(Required) First Name Last Name Email(Required) Phone(Required)Address(Required) Street Address City State / Province / Region How did you hear about Calm Canines Shopping ?Who is your dog reactive to?(Required) Select All Other dogs People Agree(Required) I certify that my dog is current with their Rabies vaccination as required by the State of Connecticut.Agree(Required) I understand that I must remain in control of my dog at all times (i.e. secured with standard non-retractable leash)Agree(Required) I understand that NorthPoint Pets & Co. is not responsible for any injuries to pets or owners.Agree(Required) I understand that if my dog urinates on products, I may be asked to pay for them.Agree(Required) I understand to be eligible for a refund, I must cancel at least 48 hours before my scheduled appointment.Clients: I understand that my dog, my guests, or I may be videotaped or photographed and that these images become the property of NorthPoint Pets & Company. I agree to release, hold harmless, acquit, will indemnify, and forever discharge the corporation from all, and in all manner of action and actions, suits, damages, judgments, executions, claims, and demands whatsoever, in law or in equity, which I or any other person I have with me during my time at NorthPoint Pets & Company. I agree that I have read and understand the terms and conditions for NorthPoint Pets & Company's Calm Canines: An Exclusive Shopping Experience. Signature(Required)Date(Required) MM slash DD slash YYYY [vc_column width=”1/4″]