VETS FORM

Your First & Last Name*

Phone*

Email*

Your Full Address - including Postcode*

Emergency Contact Name & Phone Number*

_____________________________

1st Pet : Name & Details*

(For example: THUMPER, Male, 3yrs, black & white, rex rabbit)

2nd Pet : Name & Details

(For example: Daisy, Female, 4yrs, brown, lop rabbit)

Tick anything that your pets have ever had

PMH*

♂ Male - Neutered,

♂ Male - NOT Neutered,

♀ Female - Spayed,

♀Female - NOT Spayed,

Stopped eating,

Mites or skin condition,

Stress in a new environment,

Dental issues or surgery,

Something with their eyes,

Something with their ears,

Lump or tumour,

Bladder stones or incontinence,

Doesn’t eat their cecotropes,

Runny nose or sneezing,

Sore hocks,

EC - Ecuniculi (head tilt or hind leg paralysis),

Broken bones/toes or dislocation,

Amputated limb,

Visible scars ,

Ultrasound, CT or MRI scan

Has had something not listed.

Please give full details of any conditions you ticked or any illness that we have not listed.

Vet Details*

(Vet Surgery, Address and Phone Number)

________________

If your pet develops a new illness before their holiday you must let us know so we can work out if we can still board them

________________

By continuing you agree to our Terms and Conditions and confirm that all medical details are correct and that any medical expenses will be paid by you (the owner of the above pet/s) should your they need to see a vet.

Telephone: 07772655505

Email:

gardenlodgebunnyretreat@gmail.com

Garden Lodge Bunny Retreat

for

VACANCY ANNOUNCMENTS,

Rabbit Care Information

Updates and more...

Altrincham, Hale, Bowdon, Timperley, Sale, Lymm, Oldham, Rochdale, Stockport, Eccles, Urmston, Flixton, Old Trafford, Didsbury, Cheadle, Cheadle Hulme, Stratford, Knutsford, Alderney Edge, Crewe, Middlewich, Winsford, Congleton, Frodsham, Warrington, Liverpool, Ellesmere, Widnes, Newton-le-Willows, Bollington, Hyde, Middleton, Heywood, Bolton, Chorley, Rufford, Southport, Preston, Blackburn, Rawtenstall, Macclesfield, Chester, Cheshire, Manchester, Trafford, Greater Manchester, Tameside, Lancashire, United Kingdom