VIP Health Club Application Form2018-09-04T12:50:29+00:00

VIP Health Club Application Form

Enrol your pet today it is easy.

  • You can call into our Wollaston Clinic 59 Mortlake Road Warrnambool and fill out a form
  • Ring us on 5561 6911 and we can fill in the form for you
  • Complete the form below and hit the submit button
  • Please make sure you read the Terms and Conditions

I would like to enrol my pet in the Very Important Pet Health Club

Pet's Name:
Breed:
Weight:
Age:
Birthday:

Details of pet owner
Owner's Name:
Client Number (if you are a client of The Vet Group:
Mailing Address:

Telephone:
Email:

Payment Details
Please contact me to organise my
Monthly Payments of $35Annual Payment

Please organise to have my pet's records transferred to The Vet Group
YesNo

Name of previous vet clinic:

I have read and agree to the Terms and Conditions