Make appointment

Dear Pet Owners,

You can use this form to book appointments at the Veterinary Practice Wagner .Berlin,
located at Finowstraße 14, 10247 Berlin.

We will confirm your appointment request by email.

Thank you for your trust!

Sincerely,

Henrik Wagner

Appointment type

gen. CheckUP

Check-Up
🕑 25 min

Advice

general advice
🕑 20 min

Bloodwork

Bloodwork
🕑 25 min

Vaccination

Vaccination
🕑 25 min

Little Things

Anal gland emptying
🕑 5 min
Clipping Nails
🕑 5 min

Veterinarian

Day

Time

Visit details

Fields marked with * are mandatory. All other fields are optional and do not need to be filled in.

Title
First name*
Surname*
Street
House no.
Postal code
City
Date of birth

Contact details

E-mail address*

Please enter your telephone and mobile number separately with the country code (+49 for Germany) and the phone number.

Phone no.

Phone no.

Mobile no.*

Mobile 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.

Patient name*
Breed
 
Date of birth
Colour
Transponder no.
Passport no.

Visit reason*

GDPR consent

For the proper treatment and billing of your animals, the storage of certain personal data is necessary, for which we request your consent below.

As the pet owner, I agree that the veterinary practice may store and use the following data to provide the best possible care:
• my address,
• my contact information (e.g., telephone number, email address),
• data related to the treatment of my animals, and
• curative treatments and medications administered.

I agree that my data may be shared, to the extent necessary, with:
• external laboratories,
• external service providers necessary for billing (e.g., clearinghouses),
• pet registries (e.g., TASSO),
• other veterinary practices in the case of a referral, and
• external service providers for communication purposes with the practice.

Furthermore, data will only be shared with third parties within the legal framework, i.e., only after obtaining my explicit consent.

I agree to receive information from the practice about upcoming vaccinations for my animals and to be kept up-to-date with current information from the practice.

I can request information about the scope of the stored data at any time.

I have been informed that this declaration is voluntary and can be revoked by me at any time. In this case, any data already collected will be deleted.

Treatment contract

I confirm that I am the owner of the animal and therefore authorized to enter into a contract for the performance of necessary treatments and surgeries. I further confirm that I am willing and able to bear the resulting costs. In this context, I declare that I am not currently involved in any legal debt proceedings. If I am not the owner of the animal, I confirm that I am acting on the express instructions of the animal's owner. If no authorization is given, or if the animal's owner denies having such authorization, I hereby confirm that I will bear the costs arising from the treatment. To the extent necessary for diagnosis, I authorize you to obtain services from third parties (laboratory tests, etc.) on my behalf and at my expense.

I hereby confirm the accuracy of my statements and commission you to examine and/or treat my animal, assuring you that I am authorized to do so. I acknowledge that after the examination and/or treatment of my animal, I must pay the treatment costs in cash, by debit card, or by credit card. Follow-up treatments are also subject to this agreement.

By signing below, I agree to the treatment agreement and the data protection consent form provided, within the scope of its intended purpose.

 
 
Please sign in the following field:

City
Date
GDPR consentImprint