County Equine / County Canine – County Equine and County Canine offers a service combining traditional veterinary medicine alongside additional therapies.

Your Details

Full Name*

First Last

Contact Number*

Email Address*

Address*

Street Address City County Postcode

Patient Details

Animal*

Horse
Dog
Cat

Details of Horse

Name*

Type*

Age*

Stable Address*

Street Address City County Postcode

Details of Dog

Name*

Breed*

Age*

Details of Cat

Name*

Breed*

Age*

Usual Veterinary Surgeon

Your Veterinary Surgeon*

Name*

Email Address*

Services

Services you are interested in*

Acupuncture
Additional Opinion
Chiropractic
Laser Therapy
Career Coaching and Mentorship
Online Consultation (Triage Service)

Short History / Message

In an effort to reduce emissions and footprint during County Equine’s work we are now using an electric-hybrid vehicle.

I am happy to allow the attending veterinary surgeon to plug-in their electric vehicle (EV) at the start of the consultation via

standard 3 point plug socket (approx charge cost of £0.53/hour)
EV charging point

Here at County Equine Ltd, we take Data Protection and the information we hold about you seriously.

From 25th May 2018, the new EU General Data Protection Regulations (GDPR) will be coming into effect. We have updated our Privacy Policy in order to comply with the new requirements of this law.

County Equine Ltd will never give away or sell your personal data to a third party or contact you for marketing purposes.

In submitting an appointment request you consent to us sharing your data with your primary veterinary surgeon and/or insurance company. Should you wish to check or amend your consent option, please email info@countyequine.co.uk for further information.

*

I accept the terms and conditions with respect to GDPR and consent to sharing data with my primary veterinary surgeon and/or insurance company. *

Name

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Dr Marvin J.Firth MRCVS