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01227 470033
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01795 532180
Whitstable
01227 272213
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Pre appointment questionnaire – to be completed ONCE your appointment has been RESERVED
Date and time of your appointment*:
Branch appointment made at*:
Owner's Contact Details
Title*:
Dr
Mr
Mrs
Miss
Ms
Your Full Name**:
Email**:
Contact Number*:
House name/number**:
Street**:
City**:
Postcode**:
Travel Details
Who will be travelling with the pet?*:
Owner
Person who has authorisation in writing from the owner to travel with the pet
Designated carrier contracted by the owner to travel with the pet
The name of the person travelling with the pet*:
The phone number of the person travelling with pet*:
Enter the address of your pet's final destination*:
Enter the postcode of the final destination*:
The country you will arrive in FIRST*:
Any other countries you will be travelling through*:
Select the date of travel*:
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Now
Pet details
Patients' Names*:
Your pet's species**:
Pet Breed*:
Your pet's sex*:
Male
Female
Pet Colour*:
Pet's age*:
Neutered?*:
Yes
No
Unsure
Date of your pet's rabies vaccination (Must be up to date and have been given at least 21 days before travel.)*:
Calendar
Now
Does your pet already have a passport?*:
Yes
No
Your Pet's Microchip ID (if known)*:
Pet 2 Details
The name of the second pet:
The species of the second animal:
Pet Breed:
YOUR PET'S SEX:
Male
Female
The colour of the second pet:
The second pet's age:
Is your pet neutered?:
Yes
No
Unsure
The date of your pet's rabies vaccination (Must be up to date and have been given at least 21 days before travel.):
Calendar
Now
Does this pet already have a passport?:
Yes
No
Your Pet's Microchip ID (if applicable):
Pet 3 Details
The name of the third pet:
The species of the third animal:
Pet Breed:
Your Pet's Sex:
Male
Female
The colour of the third pet:
The third pet's age:
Is your pet neutered?:
Yes
No
Unsure
Date of your pet's rabies vaccination (Must be up to date and have been given at least 21 days before travel.)*:
Calendar
Now
Does this pet already have a passport?:
Yes
No
Your Pet's Microchip ID number:
I have read and agreed to the
privacy notice
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I am happy to receive Practice/Pet Care advice :
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About Us
Locating Us
Meet the Team
Offers
Positive Pawprint
Careers
Services
Click & Collect
Pet Nutrition
Pet vaccinations
Pet wellness screening
Puppy Parties
Repeat Prescriptions
Animal Health Certificate
Advice
Insurance
Pet Travel
Post Operation Care
Pet Health Club®
Online Payment
Contact Us
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Locating Us
Book an Appointment
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