Register Online

If you’d like to register with Dereham Vets, please complete the following form.

Your contact details

We need some simple contact details for you first.

Name(Required)

Title First Last

Email(Required)

Mobile

Address(Required)

House Name/Number Address Line 2 Village/Town/City County Post Code

About your Animal(s)

Please provide the necessary information to register your animal(s).

Now tell us about your animals

Animal Name	Animal's DOB	Other Details	Has your animal been abroad?	Actions

There are no Animals.

Previous Practice Name(Required)

Terms and Conditions

We ask for payment at the time of examination or treatment.

Unpaid accounts will be subject to an interest charge of 8% per month. Any payments received after month end will be shown on your next account.

If your account remains unpaid for 60 days, we regret that we will suspend your credit facilities and your invoice will be forwarded to our debt collection agency.

Please tick to show you understand the terms and conditions.(Required)

I understand and accept the terms and conditions

I confirm I am over the age of 18 years old

Tick all that apply

I consent for medical histories to be obtained from my previous vet

I would like to receive email and text reminders

I would like to receive promotional information

Register Online

Your contact details

About your Animal(s)

Terms and Conditions

Dereham Vets Ltd

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