Register Your Pet

1 - Select all of the services required:

Register Your Pet

Request An Appointment

Shires Reward Scheme Registration

2 - A few details about yourself:

Title *

Mr Mrs Miss Ms Dr

First name *

Surname *

Address *

City/Town *

Postcode *

Email *

Telephone

Mobile

Are you a new or existing customer? *

- Select - Existing New

Branch *

Stone Stafford Eaton Park Eccleshall Gnosall Loggerheads

3 - A few details about your pet(s):

You can register up to 10 pets using this form. Select the 'Add Another Pet' button to add more pets.

Pet details

Pet's name

Age

Gender

- Select gender - Female Male

Species

Breed

Colour

Would you like to add another pet to your account? Add Another Pet

Request an appointment:

Preferred date

Preferred time

- Select - AM PM Any Time

Reason for appointment

- Select - Consultation Vaccination Neutering Microchipping Emergency Other

Shires Reward Scheme registration:

How did you hear about our Shires Reward Scheme? *

Email Website Social media In the practice Search engine Other

Do you have other pets? *

No Yes

Form submission

I would like to receive newsletters and relevant promotions by Email

I agree to the Privacy Statement *

Captcha *

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