Example of an online registration form

WELCOME TO ------- VETS AND THANK YOU FOR REGISTERING ONLINE
Surname:
First Name:
Initials/Title:
Address:
Postcode:
Home Phone No:
Other Phone No:
Email Address:*
Where did you hear about us: - (Please Specify)
How did you find our Website:
PET DETAILS
Number of Pets
Pet 1 Name:
Pet 1 Species:
Pet 1 Breed:
Pet 1 Sex
Pet 1 Neutered:

Yes No
Pet 1 Colour:
Pet 1 Age/Date of Birth:
Month Day Year
Pet 1 LAST VACCINATION:
Month Day Year
Which Insurance Company are you insured with:
CURRENT MEDICATIONS AND/OR RECENT TREATMENTS:
Please note that pets requiring repeat prescriptions will need to be assessed every four months for which there is a prescription evaluation fee.
Pet 2 Name:
Pet 2 Species:
Pet 2 Breed:
Pet 2 Sex:
Pet 2 Neutered:

Yes No
Pet 2 Colour:
Pet 2 Age/Date of Birth:
Month Day Year
Pet 2 LAST VACCINATION:
Month Day Year
Which insurance company are you insured with:
CURRENT MEDICATIONS AND/OR RECENT TREATMENTS:
Please note that pets requiring repeat prescriptions will need to be assessed every four months for which there is a prescription evaluation fee.
Where did you get your pets from:
Previous Vets (if relevant):
Reason for visit:
Please enter the code and press Submit:*
TERMS AND CONDITIONS OF BUSINESS

All fees MUST be paid for at the time of consultation or discharge after treatment. Payment can be by Cash Delta, Switch, Visa or Access. We operate on our standard terms and conditions of business. If you wish to see a copy, please ask the practice manager.
Please do not send children under 16 yrs with pets to the Centre unless by prior arrangement with the Veterinary Surgeon. Please do not send third parties with pets, as treatments can be complicated by lack of accurate history.
For safety reasons, please ensure that your pet is adequately restrained whilst on the premises – dogs should be on a lead and cats, rabbits, birds etc in a suitable carrier.

Thank you
Should be Empty:

Example of a returned form that you would receive in your practice e-mail inbox

Example of a returned form

Testimonials

"Arielle has been fantastic - quickly sussed out what we wanted and the look I envisaged. She has been ever helpful and patient with my constant tweaks and changes.
Can't recommend her highly enough!
I am happy to recommend Arielle's work to anyone. One of our best finds/investments of the whole project!"
Tricia Macpherson BVMS MRCVS Lomond Hills Veterinary Clinic

"We are at present, reviewing all our marketing strategies and have realised that our website is probably one of the biggest source of information for potential new clients, employees, etc"
Quote from Hampton Park Vets

"We approached Professional Veterinary Websites based on a recommendation from another practice whose website we liked. Arielle grasped the concept of our “brand” immediately and within days had a website up and running that accurately reflected the values that we wanted to portray via our website: caring, compassionate, pristine and professional, with a bit of fun thrown in. With all of the other draws on my time as a vet and as a start up business, it’s been great to know that I can delegate the important task of web presence to somebody who’s got a track record in delivering, as well as understanding the needs of the practising vet.
Arielle also provides monthly articles and updates our website as soon as requested.
For cost-effective website provision, I’d recommend Professional Veterinary Websites to any practice – start up or established - that wants the website that they deserve" Steve Hallahan Director - Riverforest Veterinary Centre Leixlip

"We are really pleased with our website. Arielle has made the whole design and set up process extremely easy and any updates we request are carried out promptly and to a high standard.
Excellent value web design, well worth it! "
Hannah Wright - Clinical Director - Riverside Veterinary Clinic in Bewdley

"We are delighted with our new website."
Andrew Draper BVMS MRCVS - Oak House Veterinary Centre

Example of an online registration form

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