Equine registration form

Wendover Heights Veterinary Centre

Tring Road, Halton, Aylesbury, Bucks HP22 5PN 01296 621840

(fields marked * are required fields)

There is space to register 2 horses per form - please submit another form for additional horses. Alternatively, you can email the information to registrations@whvc.co.uk, call in or telephone the practice. Please note that we aim to process your registration by the end of the working day following its submission.

Information recorded on this page will be used for internal use only and will not be disclosed to third parties.

Height

Colour

Markings

Pet insurance company

Policy number

Microchip number if applicable

Address where your horse is kept

Postcode

Title*

Forename or initials*

Surname*

House number/name*

Address*

Town*

County*

Postcode*

Home telephone*

Work telephone

Mobile

E-mail

Horse's name*

Horse's date of birth/age*

Breed

Sex

Colour

Markings

Pet insurance company

Policy number

Microchip number if applicable

Address where your horse is stabled*

Postcode

Horse's name

Horse's date of birth/age

Breed

Sex

Name and address of

previous veterinary surgeon

if applicable

I confirm that I have read

and agree to Wendover

Heights Veterinary Centre’s

Terms and Conditions

of Business and that I am over 18 years of age*

Are you already a WHVC client?

How did you hear about us,

e.g. recommended,

Yellow pages, Phonebook,

internet, etc.