Pet Vets
Papatoetoe

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Papatoetoe

Manurewa

First Name

Last Name

Address

Suburb

Post Code

Home Phone

Mobile Phone

Email

Previous Veterinary Clinic

Are you happy with us to request records from the previous clinic?

Yes

No

Preferred method of communication for reminders, follow-ups, reports, etc.

Mobile (texts mostly)

Email

Post

Pet Details

Name

Type

Breed

Age

Gender

Desexed

Vaccinated

Insured

Other information

All accounts must be paid at the time services are rendered

We accept Cash, Eftpos, Visa and Mastercard.

I agree that the information provided by me in this application is true and correct.

I understand that payment is required at the time of treatment. For any amount remaining unpaid after 7 days, I agree to be liable for any collections costs associated with recovery of the accounts.