Register online Not a customer yet? Register quickly and easily using the form below. 1General informationName*First name*Street*House number*Postal code*Place*Telephone/Mobile*E-mail address* Ik wil dat Dierenkliniek Spaarne contact opneemt om een eerste afspraak te maken. 2Your pet(s)You can enter a maximun of two pets.If you have more then two pets, please contact us or fill in a second form after your finished.Pet 1Name pet*SexMaleFemaleUnknownSpecific animalBreedDate of birthNeuteredYesNoUnknownChippedYesNoUnknownChipnumberInsuranceYesNoUnknownWhich insuranceNext vaccinationPet 2 Add a second pet... Name pet*SexMaleFemaleUnknownSpecific animalBreedDate of birthNeuteredYesNoUnknownChippedYesNoUnknownChipnumberInsuranceYesNoUnknownWhich insuranceNext vaccinationComments If you’re animal had a sickness in the past and/or is taking medication, please inform us so we can check important details. Schrijf mij in op de nieuwsbrief van Dierenkliniek Spaarne * Ik ga akkoord met het privacybeleid CommentsThis field is for validation purposes and should be left unchanged.