Fields marked with * are mandatory. All other fields are optional and do not need to be filled in.
Contact details
Please enter your telephone and mobile number separately with the country code (+49 for Germany) and the phone number.
Phone no.* (or enter a mobile no.)
Mobile no.* (or enter a landline no.)
Patient
If you would like to book an appointment for more than one animal, please first make the booking for just one animal. Once you have completed your appointment booking, you will then have the opportunity to book appointments for additional animals.
Pet insurance
Visit reason*
GDPR consent
For the proper treatment of your animals and the associated billing, it is necessary to store certain personal data, for which we ask for your consent below.
As an animal owner, I agree that the veterinary practice may store and use the following data for the purpose of providing the best possible care:
• my address,
• my contact details (e.g. telephone number, email address),
• data related to the treatment of my animals, and
• records of curative treatments and the administration of medications.
I agree that my data may be shared, insofar as this is necessary, with:
• external laboratories,
• external service providers required for billing (e.g. accounting centres),
• pet registries (e.g. TASSO),
• other veterinary practices in the event of a referral, and
• external service providers for the purpose of communication with the practice.
Beyond this, data will only be passed on to third parties within the legal framework, meaning only with my renewed consent if required.
I agree
• to be informed by the practice about upcoming vaccinations for my animals, and
• to receive current information from the practice.
I may request information about the scope of stored data at any time.
I have been informed that this declaration is made voluntarily and that I may revoke it at any time. In this case, data already collected will be deleted.
Treatment contract
I hereby confirm that I am the owner of the animal and therefore authorized to enter into a contract for the performance of necessary treatments and surgical procedures. I further confirm that I am willing and able to bear the costs arising from these procedures. I declare that, at the time of making this statement, I am not involved in any court-administered debt proceedings. If I am not the owner of the animal, I confirm that I am acting on the explicit instructions of the animal’s owner. If I am not authorized or if the animal’s owner disputes my authorization, I hereby confirm that I will assume responsibility for all costs arising from the treatment. Insofar as it is necessary for diagnostic purposes, I authorize you to obtain services from third parties (such as laboratory tests) in my name and at my expense.
I hereby confirm that my statements are accurate and authorize you to examine and/or treat my animal, assuring you that I am entitled to do so. I acknowledge that after the examination of my animal, I must pay the treatment costs immediately in cash, by debit card, or by credit card. Follow-up treatments are likewise subject to this agreement.
By signing, I consent to the treatment contract and to the data protection declaration as described, within the scope of its intended purpose.
Please sign in the following field:
Please note that this appointment can only be requested and not booked. We will contact you immediately regarding your appointment request.