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VETS FORM

Your Rabbits Details*

(For example: Roy, Male, 5yrs, Black & White, lop rabbit)

Your First & Last Name*

Your Address*

(We need your FULL address and POSTCODE)

Your Phone Number*

Your Partners Name and Phone Number

Emergency Contact Name & Phone Number*

(Someone who is not going away with you)

_____________________________

Past Medical History

Tick anything that your pet has had

PMH*

Vaccinated within the last 12 months

♂ 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

My rabbit bites

Has had something not listed.

Please give full details of any condition you ticked above or anything that we have not listed.

Which vet are you registed with?

Vet Details*

(We need:

Vet Name, Surgery Name, Address & Phone Number)

Vet Fees

£*

I will pay for any veterinary fees myself and claim from my pet insurance.

I do not have pet insurance - I confirm I will pay any vets bills myself before my pet is discharged from the vets care.

No, I do not agree to pay any vets fees.

_____________________________

If your pet develops a new illness before their holiday you must let us know.

By continuing you agree to our Terms and Conditions and confirm that all medical details are correct.

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