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Exotic Animals Insurance
Exotic Animals Free Policy Registration
Exotic Trial Policy registration
Telephone:
0800 255 426
Email:
Your Details
Your Details
Business/Practice name
*
Petcover Registration No
*
Phone
Email
Your Details
Client Details (Pet Owner)
Title
Ms
Mr
Mrs
Miss
Dr
Prof
Other
Name
First
Last
Is the client over 18?
Yes
No
Phone
Email
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Your Details
Pet Details
Exotic Type
*
Small Mammal
Bird
Bird of prey
Reptile
Turtle/Tortoise
Species/Breed
Pet Name
Pet Gender
Birth/Hatch Date
Purchase Price
Your Details
Questions
Pets Microchip Number
Has the pet been seen by a vet in the past 24 hours?
*
Select one
Yes
No
Does the pet have an existing condition; or any deformity; or has not shown any signs of illness or injury; or been seen by a vet; or been on any medication; either now or in the past?
*
Select one
Yes
No
Provide details of any existing condition(s), any deformity, sign(s) of illness or injury, or medication the pet has had, either now or in the past.
Provide details of when the pet showed any sign(s) of illness or injury, was seen by a vet or received medication.
Please provide the name, address and telephone number of each vet that has seen the pet during ownership.
Does the pet have any other insurance policy covering them currently or has this pet been issued an introductory 4 week trial policy previously?
*
Select one
Yes
No
Have you advised the owner that they are receiving the introductory cover?
*
Select one
Yes
No
Have you advised the owner that the cover has a 3 day waiting period for an injury and a 7 day waiting period for illnesses?
*
Select one
Yes
No
Do you agree to the following? The information provided is accurate and complete to the best of your knowledge and you are aware that any incorrect information may result in the policy being cancelled and/or any claim not being paid or a reduced amount paid.
*
Select one
Yes
No
Please confirm the above statements about you and your pet are true. Yes/No
*
Select one
Yes
No
Comments
Consent
*
I agree to the privacy policy.
Comments
This field is for validation purposes and should be left unchanged.