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Pet Owner Details
Title
-
Dr
Miss
Mr
Mrs
Ms
Other
Prof.
First Name
Middle Name
Last Name
Phone
Email
Pet Owner Address
Address 1
Address 2
City
County
Postcode
Country
-
United Kingdom
Australia
Ireland
Netherlands
Hong Kong
Saudi Arabia
Czech Republic
Korea, Republic Of
United States
Spain
Nigeria
Portugal
Germany
Chad
United Arab Emirates
Oman
Austria
Mauritius
Poland
Lao People's Democratic Republic
Singapore
Italy
Norway
Sweden
Pakistan
France
Malawi
Romania
Uganda
China
Cyprus
Philippines
Latvia
Israel
Taiwan, Province Of China
Hungary
Qatar
Macao
Kuwait
Lithuania
Guernsey
Canada
Greece
Slovenia
Japan
Turkey
Brazil
Kenya
Zimbabwe
Jersey
Libya
South Africa
Malaysia
Denmark
Finland
Luxembourg
Saint Kitts And Nevis
Saint Lucia
Wales
Mauritania
SN2 2LZ
Belgium
Switzerland
The Pet lives at the same address
Pet's Address
Address 1
Address 2
City
County
Postcode
Country
-
United Kingdom
Australia
Ireland
Netherlands
Hong Kong
Saudi Arabia
Czech Republic
Korea, Republic Of
United States
Spain
Nigeria
Portugal
Germany
Chad
United Arab Emirates
Oman
Austria
Mauritius
Poland
Lao People's Democratic Republic
Singapore
Italy
Norway
Sweden
Pakistan
France
Malawi
Romania
Uganda
China
Cyprus
Philippines
Latvia
Israel
Taiwan, Province Of China
Hungary
Qatar
Macao
Kuwait
Lithuania
Guernsey
Canada
Greece
Slovenia
Japan
Turkey
Brazil
Kenya
Zimbabwe
Jersey
Libya
South Africa
Malaysia
Denmark
Finland
Luxembourg
Saint Kitts And Nevis
Saint Lucia
Wales
Mauritania
SN2 2LZ
Belgium
Switzerland
Pets Details
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Direct Debit Payment Details
Name on the account
Account Number
Sort Code
The Direct Debit Guarantee
This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
If there are any changes to the amount, date or frequency of your Direct Debit Merlin Simple Payment Solutions Ltd will notify you 7 working days in advance of your account being debited or as otherwise agreed. If you request Merlin Simple Payment Solutions Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
If an error is made in the payment of your Direct Debit, by Merlin Simple Payment Solutions Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society – If you receive a refund you are not entitled to, you must pay it back when Merlin Simple Payment Solutions Ltd asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us at office@merinsps.co.uk
Confirmation
I understand that this is NOT an insurance policy
I read the
Terms and Conditions
of the agreement
I am the account holder & the only person required to authorise Direct Debit payments on this account
Privacy Policy
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Name
Birth Date
Can be approximate if you don't know the exact date.
Species
-
Dog
Cat
Breed
-
[Dog] Airedale Terrier
[Dog] Akita
[Dog] Alaskan Malamute
[Dog] American Bulldog
[Dog] American Bully (Standard)
[Dog] American Eskimo Dog (Miniature)
[Dog] American Eskimo Dog (Standard)
[Dog] Am. Staffordshire Terrier
[Dog] American Pit Bull Terrier
[Dog] Australian Cattle Dog (Heeler)
[Dog] Australian Kelpie
[Dog] Australian Shepherd
[Dog] Austrialian Terrier
[Dog] Barbet
[Dog] Basenji
[Dog] Basset Hound
[Dog] Beagle
[Dog] Bearded Collie
[Dog] Beauceron
[Dog] Bedlington Terrier
[Dog] Belgian Malinois
[Dog] Belgian Tervuren
[Dog] Bernese Mountain Dog
[Dog] Bichon Frise
[Dog] Black and Tan Coonhound
[Dog] Bloodhound
[Dog] Bluetick Coonhound
[Dog] Boerboel
[Dog] Border Collie
[Dog] Border Terrier
[Dog] Boston Terrier
[Dog] Bouvier des Flandres
[Dog] Boxer
[Dog] Boykin Spaniel
[Dog] Bracco Italiano
[Dog] Briard
[Dog] Brittany
[Dog] Bull Terrier (Standard)
[Dog] Bull Terrier (Miniature)
[Dog] Bulldog
[Dog] Bullmastiff
[Dog] Cairn Terrier
[Dog] Cane Corso
[Dog] Cardigan Welsh Corgi
[Dog] Catahoula Leopard Dog
[Dog] Caucasian Shepherd (Ovcharka)
[Dog] Cavalier King Charles Spaniel
[Dog] Chesapeake Bay Retriever
[Dog] Chihuahua (Long hair)
[Dog] Chihuahua (Smooth)
[Dog] Chinese Crested
[Dog] Chinese Shar-Pei
[Dog] Chinook
[Dog] Chow Chow
[Dog] Clumber Spaniel
[Dog] Cockerpoo
[Dog] Cocker Spaniel
[Dog] Collie (Smooth)
[Dog] Collie (Rough)
[Dog] Coton De Tulear
[Dog] Dachshund (smooth)
[Dog] Dachshund (wire/long haired)
[Dog] Dalmatian
[Dog] Doberman Pinscher
[Dog] Dogo Argentino
[Dog] Dutch Shepherd
[Dog] English Setter
[Dog] English Shepherd
[Dog] English Springer Spaniel
[Dog] English Toy Spaniel
[Dog] English Toy Terrier
[Dog] Eurasier
[Dog] Field Spaniel
[Dog] Finnish Lapphund
[Dog] Finnish Spitz
[Dog] Flat Coat Retriever
[Dog] French Bulldog
[Dog] German Pinscher
[Dog] German Shepherd Dog
[Dog] German Shorthaired Pointer
[Dog] Giant Schnauzer
[Dog] Glen of Imaal Terrier
[Dog] Golden Retriever
[Dog] Gordon Setter
[Dog] Great Dane
[Dog] Great Pyrenees
[Dog] Greyhound
[Dog] Harrier
[Dog] Havanese
[Dog] Irish Setter
[Dog] Irish Terrier
[Dog] Irish Wolfhound
[Dog] Italian Greyhound
[Dog] Japanese Chin
[Dog] Japanese Spitz
[Dog] Keeshond
[Dog] Komondor
[Dog] Kooikerhondje
[Dog] Kuvasz
[Dog] Labrador Retriever
[Dog] Lagotto Romagnolo
[Dog] Lancashire Heeler
[Dog] Leonberger
[Dog] Lhasa Apso
[Dog] Maltese
[Dog] Miniature American Shepherd
[Dog] Miniature Pinscher
[Dog] Miniature Schnauzer
[Dog] Newfoundland
[Dog] Norfolk Terrier
[Dog] Norwich Terrier
[Dog] Nova Scotia Duck Tolling Retriever
[Dog] Olde English Bulldogge
[Dog] Old English Sheepdog
[Dog] Papillon
[Dog] Parson Russell Terrier
[Dog] Patterdale Terrier (Smooth or Broken)
[Dog] Patterdale Terrier (Rough)
[Dog] Pekingese
[Dog] Pembroke Welsh Corgi
[Dog] Pharaoh Hound
[Dog] Plott
[Dog] Pointer (English)
[Dog] Pomeranian
[Dog] Poodle (Miniature)
[Dog] Poodle (Standard)
[Dog] Poodle (Toy)
[Dog] Portugese Water Dog
[Dog] Presa Canario
[Dog] Pug
[Dog] Puli
[Dog] Pumi
[Dog] Rat Terrier
[Dog] Redbone Coonhound
[Dog] Rhodesian Ridgeback
[Dog] Rottweiler
[Dog] Russian Toy
[Dog] Saluki
[Dog] Samoyed
[Dog] Schipperke
[Dog] Scottish Deerhound
[Dog] Scottish Terrier
[Dog] Shetland Sheepdog (Sheltie)
[Dog] Shiba Inu
[Dog] Shih Tzu
[Dog] Shiloh Shepherd
[Dog] Siberian Husky
[Dog] Silky Terrier
[Dog] Smooth Fox Terrier
[Dog] Soft Coated Wheaten Terrier
[Dog] Spanish Water Dog
[Dog] Spinone Italiano
[Dog] St. Bernard
[Dog] Staffordshire Bull Terrier
[Dog] Standard Schnauzer
[Dog] Swedish Vallhund
[Dog] Thai Ridgeback
[Dog] Tibetan Mastiff
[Dog] Tibetan Spaniel
[Dog] Tibetan Terrier
[Dog] Toy Fox Terrier
[Dog] Vizsla
[Dog] Weimaraner
[Dog] Welsh Springer Spaniel
[Dog] West Highland White Terrier
[Dog] Whippet
[Dog] White Shepherd
[Dog] Wire Fox Terrier
[Dog] Wirehaired Pointing Griffon
[Dog] Yorkshire Terrier
[Cat] Abyssinian
[Cat] Asian
[Cat] Australian Mist
[Cat] Balinese
[Cat] Bengal
[Cat] Birman
[Cat] British Shorthair
[Cat] Burmese
[Cat] Chartreux
[Cat] Chinchilla
[Cat] Cornish Rex
[Cat] Devon Rex
[Cat] Domestic shorthair
[Cat] Domestic longhair
[Cat] Egyptian Mau
[Cat] Exotic Shorthair
[Cat] Korat
[Cat] LaPerm
[Cat] Lykoi
[Cat] Maine Coon
[Cat] Manx
[Cat] Nebelung
[Cat] Norwegian Forest
[Cat] Ocicat
[Cat] Old Fashioned Siamese
[Cat] Oriental
[Cat] Oriental Long Hair
[Cat] Persian
[Cat] RagaMuffin
[Cat] Ragdoll
[Cat] Russian Blue
[Cat] Selkirk Rex
[Cat] Siamese
[Cat] Siberian
[Cat] Singapura
[Cat] Snowshoe
[Cat] Sokoke
[Cat] Somali
[Cat] Sphynx
[Cat] Suffolk Chocolate
[Cat] Tonkinese
[Cat] Toyger
[Cat] Turkish Van
[Cat] Turkish Vankedisi
[Dog] Goldendoodle
[Dog] Mixed Breed
[Dog] Labradoodle
Gender
-
Male
Female
Weight Bracket
-
0 - 10kg
0 - 10Kg
10.1 - 20Kg
20.1 - 40Kg
40.1 - 65Kg
> 65 Kg
Neutered
-
Yes
No
I don't know
Microchipped
-
Yes
No
I don't know
Choose a Health Plan
The Health Care Plan most suited to the pet
-
Members Club - Cat - £16.50 per month
Members Club - Small Dog - £17.00 per month
Members Club - Medium Dog - £18.00 per month
Members Club - Large Dog - £20.00 per month
Members Club - Extra Large Dog - £23.00 per month
Members Club - Giant Dog - £28.00 per month
Date of first Direct Debit collection