Dog Enrollment form

We encourage you to answer the next few pages of questions with absolute transparency and to the fullest extent of your knowledge. This helps us better tailor a membership plan.

Your name? *

Your email? *

Your address? *

Your phone? *

How many pets do you have? *

Do they all have up to date veterinary care, vaccines, etc? YesNo

Have you or anyone else been found legally liable for damage or injury caused by your pet? YesNo

Can you have all clinical histories from all veterinary practices of your pet’s past sent to Mammal Healthcare? YesNo

Please have past veterinary practices send full clinical history, lab results, images and diagnostics such as X-Rays. This is important for us to give you an initial fair price quote. Please have your previous vets send to [email protected] with pet name and surname in the subject heading. Thank you.

You will be required to always be the one to present with your pet, however emergencies happen, you may nominate one other person to present in time of emergency with your pet?

This person's full name?

This person's relationship to you?

This information can be changed later but will take 7-14 business days to go into effect tick box that they understand.
You agree to always communicate with us and work with us in our efforts to give you and your pet(s) the best life. It is important that you adhere to schedule and follow the rules with cancellations and understand what can be fineable offenses in your membership plan. We aim to achieve the best for pets.

Agree YesNo

Your date of birth?

What is your household income? :

Are you receiving Universal Credit? YesNo

Contact Us

Our Services