Title
*
Mr
Mrs
Ms
Miss
Dr
Sir
Capt
Prof
Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact telephone number (mobile or landline)
*
Alternative contact telephone number
Email address
*
Which surgery would you prefer to use mostly?
*
Biggar
Peebles
What type of pet would you like to register?
*
Dog
Cat
Rabbit
Ferret
Guinea pig
Hamster
Other small mammal
Bird
Reptile
Pet's name
*
Breed
*
Colour
*
Date of birth or age
*
Sex
*
Male
Female
I don't know
Date of last vaccination
Date of last flea and worm treatments
Is your pet insured?
*
Yes
No
I don't know
Is your pet microchipped?
*
Yes
No
I don't know
Microchip number
To the best of your knowledge, has your pet come from, or travelled to, any countries outside of the UK?
*
Yes
No
If you answered yes to the question above, please give details of the country or countries
This information is required as foreign travel can widen the list of diseses your pet may have been exposed to. Knowing your pets travel history can help us consider different conditions if your pet becomes ill, and allows us to assess any risk of infection to other dogs or humans
Are you registered with another vet? If so please give details
We have a professional obligation to let your previous vet know we are going to see your pet, and to ask for any previous history. This is in your pet's interest if he or she has had any medical or surgical treatment before. It also helps transfer vaccination, flea and worming reminders etc
Please tick to give us consent to contact your current vet
Is there anything else you'd like to tell us?
If you would like to register more than one pet, you can tell us about them here
Please tick all the methods we can use to contact you about your pet(s) or your account, for example to arrange an appointment, to remind you about vaccinations, or to send a statement
*
We do not share your data with third parties unless with your permission or required by law
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