Dirty Dog Registration Form

Please complete this form prior to your visit.
Your name 
*
Address 
*
Email address 
*
Phone 
*
Dog's name 
*
Breed 
*
Weight 
*
Date of birth (or "gotcha" day) 
*
Gender
Veterinarian
Rabies due date 
*
Please attach a copy of your dog’s rabies vaccination 
*
Choose file or drag & drop here
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Come visit our pet supply store in Berlin, CT specializing in quality food, treats, and supplies for dogs. We also offer dog grooming and a self serve dog wash.