"Caring for your pets as much as you do"

Pet Registration Form Epsom

To register your pet with Winton Lodge Vets Epsom please complete the form below and submit. If you have any questions please call us.

Your Details

Title *

Name *



Address *

Street Address

Address Line 2




Phone (Home) *

Phone (Mobile) *

Phone (Business)

Email *

Surgery going to use *

Your Pet's Details

Pet's Name *

Date Of Birth (dd/mm/yyyy) *

Species (e.g. cat, dog, rabbit) *

Breed *

Colour *


Neutered *

Date of last vaccination

Date of last worming

Microchip number (if applicable)

Insurance company (if applicable)

Previous veterinary practice

Previous veterinary practice Tel

Would you like us to contact you about a query you have or to book an appointment? *

In registering with the Practice you are confirming that you have read our terms of business and that permission is given to obtain your pet’s clinical history from your previous vets.

If you make an enquiry via our web form or email but don’t hear back, please call us and we will be happy to help.

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