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TYWYN
01654 710416

CAMBRIAN VETS

professional pet healthcare

MACHYNLLETH
01654 702444

FOR EMERGENCY + OUT OF HOURS CARE CALL 01654 710416

Registering Your Pet with Cambrian Vets in Machynlleth

Thank you for wanting to register your pet with Cambrian Vets’ Machynlleth Surgery

You can either fill in the form below and one of the team will be in touch to arrange your initial consultation, or if you prefer you can download and print off a copy of the form and phone us on 01654 702444 to arrange a time to come in for your pet’s first health check with us.

Download a printable form

Please make sure that you’re happy with the practice’s terms and conditions before filling out the form. You’ll be required to check that you’ve read and accept them before you can click to submit your details. You can find our terms and conditions here.

Online Registration Form

    In an emergency, please phone the surgery immediately.

    Your Details

    First Name*:

    Surname*:

    Permanent Address (required)

    Address1*:

    Address2:

    Town*:

    County:

    Postcode*:

    Holiday Address (if here on holiday)

    Address1:

    Address2:

    Town:

    County:

    Postcode:

    Home Telephone*:

    Work Telephone:

    Mobile:

    Email Address*:

    Your Previous Vet

    Information only required if applicable

    Practice Name:

    Address1:

    Address2:

    Town:

    County:

    Postcode:

    We need to contact your previous veterinary practice to request a medical history for your pet. Please provide your address when registered there to help them find your records:

    Address1:

    Address2:

    Town:

    County:

    Postcode:

    If your pet was registered under a different name or your details differed, please include any useful information here that will help them to find your pet's history:

    Additional Agents

    If you would like to give permission for other persons to act on your behalf, or instruct us on your behalf on how to treat your pet, please give us their details below:

    Your Pet(s)

    Pet's Name*:

    Age*:

    Species*:

    Breed:

    Gender*:

    Is your pet neutered?:

    Colour of the animal*:

    Current conditions/medications your pet has/receives:

    Pet Two

    Pet's Name:

    Age*:

    Species:

    Breed:

    Gender:

    Is your pet neutered?:

    Colour of the animal:

    Current conditions/medications your pet has/receives:

    Pet Three

    Pet's Name:

    Age:

    Species:

    Breed:

    Gender:

    Is your pet neutered?:

    Colour of the animal:

    Current conditions/medications your pet has/receives:

    GDPR Compliance and Acceptance of Terms & Conditions

    I consent to my data from this form being collected and stored in line with the guidelines provided in the privacy policy:
    YesNo

    I have read and agree to the terms presented in Cambrian Vet's Terms and Conditions (click to open our Terms and Conditions in a new window). Please note, you won't be able to submit your registration without checking this box: