1. About your pet

Pet's name

Is your pet a...

Dog

Cat

Pet's breed category

Pet's breed

Pet's gender

Male Female

Pet's date of birth

Pet purchase price If you didn't pay for your pet please put 0

Has your pet been neutered/spayed?

Yes No

2. About you

Title

First name

Surname

Date of birth

Postcode

Your Address

Your Address:

House number

Address 1

Address 2

City/Town

County

Contact number (including area code)

Your preferred contact email address

3. About your policy

If your pet had an accident, developed an illness or had an injury how long would you like help with veterinary fees for?

Lifetime

Provides vet fees cover for eligible conditions for as long as the policy remains in force.

There is an annual fee limit covering the combined eligible conditions that may arise while the policy is in place and these limits restart each time the policy is renewed. There are three levels of Lifetime policies to choose from, with annual cover ranging from £2,000 to £10,000 (fuller details are provided on the next page to allow you to select the policy that best meets your needs).

Up to 12 Months

Provides vet fees cover for up to 12 months for any new eligible condition.

Each condition has a fee limit of up to £1,500 and the policy must remain in force for the cover to continue (including at annual renewal if relevant). When the limit or 12 months has passed (whichever is sooner) any further treatment required will not be covered by this policy.

When would you like your policy to start?

Please note - There is no cover in relation to vet fees or death benefits resulting from an illness that occurred prior to or within the first 14 days of your policy start date and the first 48 hours for any accidents. Any previous, existing, ongoing or reoccurring medical conditions known to you prior to purchasing the policy will also not be covered.

How did you hear about us?

Please read and tick the boxes below to confirm the assumptions stated are correct for the pet(s) you are looking to insure with us. Please note if any of our assumptions are not correct we are unfortunately unable to offer cover for your pet(s). If you are unsure about any of the assumption statements below, please call us on 0345 165 0928.

You are a resident of the United Kingdom, the owner and keeper of the pet, and the pet is kept in the United Kingdom at the address you have provided.

Your pet has no vicious tendencies or been trained to attack.

Your pet has not been the cause of any accident or legal action or third party liability claims.

You have never had any special terms imposed on a pet insurance policy covering your pet.

Your pet is not used for any guard, security, track racing, coursing, or used in connection to any business, trade, profession, commercial breeding or occupation.

Your pet must have received vaccinations/boosters within the last 12 months or as advised by your vet. If this is not the case, you accept that the medical conditions that your pet is normally protected against by such vaccinations/boosters will not be covered by this insurance policy.

Your pet does not appear on the list of unacceptable breeds (see below).

Unacceptable Breeds

I confirm my pet's pedigree declared is correct, or if either a crossbreed or a mongrel, they are not crossed with, or contain any previous mix of the following breeds: Aladseer, American Bandogge Mastiff, American Bulldog, American Indian Dog, American Pitbull Terrier, American Staffordshire Bull Terrier, Argentinian Mastiff, Australian Dingo, Boerboel, Canary Dog, Cane Corso, Czechoslovakian Wolfdog, Dogo Argentino, Dogue Brasileiros, English Bulldog, Farm Collie, Fila Brasileiro, Irish Staffordshire Bull Terrier, Japanese Tosa, Perro De Presa Canario, Pit Bull Mastiff, Pit Bull Terrier, Racing Greyhound, Sarloos Wolfhound, Thai Ridgeback, Tosa Inu, Wolf Hybrid, or any animal registered under the Dangerous Dogs Act 1991 and The Dangerous Dogs (Northern Ireland) order 1991 or Dangerous Dogs (amendment) Act 1997 or any subsequent amendments.

Keeping you up to date

We'd like to keep in touch with you to make sure you don't miss out on any of our insurance offers. If you'd rather we didn't keep in contact with you by any of the ways below, please select:

Post

SMS

Telephone

To find out more about how we protect your personal information, please read our Privacy Policy.

Don't worry, we'll keep your information safe and secure and you can opt-out at any time.

Before you proceed, please take a moment to provide us with some more information (please note this is optional):

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About You

1. About your pet

2. About you

3. About your policy

Keeping you up to date

Need help?

About You

1. About your pet

2. About you

3. About your policy

Keeping you up to date

Need help?

Assumptions

Unacceptable Breeds

Insurance Product Information Document