Pharmacy RequestOrder refills of available products "*" indicates required fields Step 1 of 10 10% Are you a registered Client with us?* Yes No Name (as presented in Passport or Gov. ID)* First Last Email* Enter Email Confirm Email Phone*Local Phone or WhatsApp NumberOwner InformationTo serve you we’ll need some information.Where will we be visiting you? Please fill out your home address below as accurately as possible.Address* Street AddressAddress Line 2* Address Line 2District*— Select Below —Bodden TownEast EndGeorge TownNorth SideProspectWest BayRed BayRum PointSavannahSeven Mile BeachSouth SoundPlease choose your nearest districtIsland*Grand CaymanCurrently only available in Grand CaymanPostal Code KY1-1234Country*Cayman IslandsCurrently only serving Cayman IslandsHow did you find out about us?*— Select Below —GoogleInstagramFacebookRadio AdReferral from ClinicReferral from a friend or familyOtherI'd rather not sayWe’d love to know how you heard about us!Which Clinic? Who was it? We’d love to thank them 🙂Other How else? Pet InformationAre your pets registered with us?* Yes No Pet One RegistrationRegister your pets info belowPet's Name* Pet’s Full NameDoes your pet bite?* Yes No I’m not sure. Picture of your pet Drop files here or Select files Accepted file types: jpeg, jpg, png, Max. file size: 3 MB, Max. files: 1. Pet Species*— Select Below —Canine (Dog)Feline (Cat)Avian (Bird)Other (Please Specify)What species are we looking at? Breed* Pet Colour* Sex*— Select Below —Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)UnsureDo you know your pets birthdate?* Yes No Birthdate* dd/mm/yyyy Let us know when your pet was born.Approximate Age* Can you give us your best guess?Years / Months*YearsMonthsPet Weight* If you’re unsure, give it your best guess.Unit for Weight*KG (Kilograms)G (Grams)LBs (Pounds)Microchip Number Has your pet seen a vet before?* Yes No Please list the Vets your pet has been to* Upload Medical Record Drop files here or Select files Accepted file types: jpeg, jpg, pdf, png, Max. file size: 5 MB, Max. files: 5. If your pet has a medical record. Please upload it here.Would you like to add another pet?* Yes, I’d like to register another pet No, this is all! Click “Next” to register another pet.Click “Next” to choose the services you’d like. Pet Two RegistrationRegister your pets info belowPet's Name* Pet’s Full NameDoes your pet bite?* Yes No I’m not sure. Picture of your pet Drop files here or Select files Accepted file types: jpeg, jpg, png, Max. file size: 3 MB, Max. files: 1. Pet Species*— Select Below —Canine (Dog)Feline (Cat)Avian (Bird)Other (Please Specify)What species are we looking at? Breed* Pet Colour* Sex*— Select Below —Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)UnsureDo you know your pets birthdate?* Yes No Birthdate* dd/mm/yyyy Let us know when your pet was born.Approximate Age* Can you give us your best guess?Years / Months*YearsMonthsPet Weight* If you’re unsure, give it your best guess.Unit for Weight*KG (Kilograms)G (Grams)LBs (Pounds)Microchip Number Has your pet seen a vet before?* Yes No Please list the Vets your pet has been to* Upload Medical Record Drop files here or Select files Accepted file types: jpeg, jpg, pdf, png, Max. file size: 5 MB, Max. files: 5. If your pet has a medical record. Please upload it here.Would you like to add another pet?* Yes, I’d like to register another pet No, this is all! Click “Next” to register another pet.Click “Next” to choose the services you’d like. Pet Three RegistrationRegister your pets info belowPet's Name* Pet’s Full NameDoes your pet bite?* Yes No I’m not sure. Picture of your pet Drop files here or Select files Accepted file types: jpeg, jpg, png, Max. file size: 3 MB, Max. files: 1. Pet Species*— Select Below —Canine (Dog)Feline (Cat)Avian (Bird)Other (Please Specify)What species are we looking at?* Breed* Pet Colour* Sex*— Select Below —Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)UnsureDo you know your pets birthdate?* Yes No Birthdate* dd/mm/yyyy Let us know when your pet was born.Approximate Age* Can you give us your best guess?Years / Months*YearsMonthsPet Weight* If you’re unsure, give it your best guess.Unit for Weight*KG (Kilograms)G (Grams)LBs (Pounds)Microchip Number Has your pet seen a vet before?* Yes No Please list the Vets your pet has been to* Upload Medical Record Drop files here or Select files Accepted file types: jpeg, jpg, pdf, png, Max. file size: 5 MB, Max. files: 5. If your pet has a medical record. Please upload it here.Would you like to add another pet?* Yes, I’d like to register another pet No, this is all! Click “Next” to register another pet.Click “Next” to choose the pet products you’d like. Pet Four RegistrationRegister your pets info belowPet's Name* Pet’s Full NameDoes your pet bite?* Yes No I’m not sure. Picture of your pet Drop files here or Select files Accepted file types: jpeg, jpg, png, Max. file size: 3 MB, Max. files: 1. Pet Species*— Select Below —Canine (Dog)Feline (Cat)Avian (Bird)Other (Please Specify)What species are we looking at?* Breed* Pet Colour* Sex*— Select Below —Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)UnsureDo you know your pets birthdate?* Yes No Birthdate* dd/mm/yyyy Let us know when your pet was born.Approximate Age* Can you give us your best guess?Years / Months*YearsMonthsPet Weight* If you’re unsure, give it your best guess.Unit for Weight*KG (Kilograms)G (Grams)LBs (Pounds)Microchip Number Has your pet seen a vet before?* Yes No Please list the Vets your pet has been to* Upload Medical Record Drop files here or Select files Accepted file types: jpeg, jpg, pdf, png, Max. file size: 5 MB, Max. files: 5. If your pet has a medical record. Please upload it here.Click “Next” to choose the pet products you’d like. Which pets are we ordering for?*Pets Name Add RemoveClick the “+” to add other petsWhich products are you interested in?* Heartgard Nexgard Nexgard Spectra Broadline for Cats Prescription Medication, Refills, Other Choose size and quantityPlease view below and choose the correct size and quantity (measured in months) you’d require. HeartgardHeartgard® Plus for dogs is a veterinarian-prescribed medication that contains ivermectin and an additional dewormer called pyrantel, which provides coverage for roundworms and hookworms. Heartgard® Plus for dogs also prevents heartworm disease by killing the larval stage of heartworms. Heartgard® Plus is intended for any-sized dog that is 6 weeks of age or older. Heartgard® Plus for dogs should be administered once a month. Heartgard*— Choose Size —Heartgard up to 25lbsHeartgard 26-50lbsHeartgard 51-100lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Heartgard Heartgard*— Choose Size —Heartgard up to 25lbsHeartgard 26-50lbsHeartgard 51-100lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Heartgard Heartgard*— Choose Size —Heartgard up to 25lbsHeartgard 26-50lbsHeartgard 51-100lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.NexGardNexGard is a beef-flavored monthly soft chewable that kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis) and the treatment and control of Black-legged (deer) tick (Ixodes scapularis), American Dog tick (Dermacentor variabilis), Lone Star tick (Amblyomma americanum) and Brown Dog Tick (Rhipicephalus sanguineus) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month.Nexgard*— Choose Size —Nexgard 4-10lbsNexgard 10.1-24lbsNexgard 24-60lbsNexgard 60.1-121lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Nexgard*— Choose Size —Nexgard 4-10lbsNexgard 10.1-24lbsNexgard 24-60lbsNexgard 60.1-121lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Nexgard*— Choose Size —Nexgard 4-10lbsNexgard 10.1-24lbsNexgard 24-60lbsNexgard 60.1-121lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Nexgard*— Choose Size —Nexgard 4-10lbsNexgard 10.1-24lbsNexgard 24-60lbsNexgard 60.1-121lbsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.NexGard SpectraNexGard SPECTRA® is a highly palatable beef-flavored chew that kills fleas before they can lay eggs, ticks and mites while eliminating gastro-intestinal worms and preventing heartworm disease, lungworm and eyeworm infections. NexGard Spectra® is a highly convenient, “all round” solution for dogs and puppies from eight weeks of age.Nexgard Spectra*— Choose Size —Nexgard Spectra 2-3.5kgsNexgard Spectra 3.6-7.5kgsNexgard Spectra 7.6-15kgsNexgard Spectra 15.1-30kgsNexgard Spectra 30.1-60kgs Quantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Spectra Nexguard Spectra*— Choose Size —Nexgard Spectra 2-3.5kgsNexgard Spectra 3.6-7.5kgsNexgard Spectra 7.6-15kgsNexgard Spectra 15.1-30kgsNexgard Spectra 30.1-60kgsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Spectra Nexguard Spectra*— Choose Size —Nexgard Spectra 2-3.5kgsNexgard Spectra 3.6-7.5kgsNexgard Spectra 7.6-15kgsNexgard Spectra 15.1-30kgsNexgard Spectra 30.1-60kgsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Spectra Nexguard Spectra*— Choose Size —Nexgard Spectra 2-3.5kgsNexgard Spectra 3.6-7.5kgsNexgard Spectra 7.6-15kgsNexgard Spectra 15.1-30kgsNexgard Spectra 30.1-60kgsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Need another size? I’d like to add more Nexgard Spectra Nexguard Spectra*— Choose Size —Nexgard Spectra 2-3.5kgsNexgard Spectra 3.6-7.5kgsNexgard Spectra 7.6-15kgsNexgard Spectra 15.1-30kgsNexgard Spectra 30.1-60kgsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Broadline for CatsProtects kittens from seven weeks age and cats against the broadest spectrum of internal and external parasites including adult fleas, flea eggs, flea larvae, ticks, heartworm larvae, hookworms, roundworms, lungworms, vesical worms and tapeworms.Broadline for Cats*— Choose Size —Broadline for Cats 2.5kgs-7.5kgsQuantity (measured in months supply)*Please enter a number greater than or equal to 1.Prescription Medications, Refills, OtherUse this space below to add any other medication, or notes to your order.Prescription Medication, Refills, OtherYou can also use this space to add more meds to your order.Upload any prescriptions Drop files here or Select files Accepted file types: pdf, png, jpg, jpeg, Max. file size: 3 MB, Max. files: 5. Delivery InformationWhere are we delivering to?* My residential address on file A different location Delivery AddressAddress* Street AddressAddress Line 2* Address Line 2District*— Select Below —Bodden TownEast EndGeorge TownNorth SideProspectWest BayRed BayRum PointSavannahSeven Mile BeachSouth SoundPlease choose your nearest districtIsland*Grand CaymanCurrently only available in Grand CaymanPostal Code* KY1-1234Country*Cayman IslandsCurrently only serving Cayman Islands The Home StretchJust a few more things and we’re good!Preferred time of delivery*— Select Below —Morning (Typically between 9a-12p)Afternoon (Typically between 1p-4p)Anytime worksMethod of Payment* Cash Debit / Credit Card Payment is due in full at the time services are rendered.Consent and SignatureThank you for taking the time to register and schedule an appointment! Just a few things and we’re set.Privacy Policy Consent* I agree to the privacy policy.Terms of Service* I have read and agree to the Terms of Service1. I am the owner (or authorized agent) of my pet. I hereby authorize and direct Eco Planet Ltd T/A The Mobile Vet Company; its veterinarians, technicians, and assistants to perform services, vaccines, treatments, diagnostics, and/or administration of extra label medications as deemed necessary or advisable in connection with or relating to the matters described in the attached estimate or the matters that have otherwise been explained by Eco Planet Ltd T/A The Mobile Vet Company; veterinarian or other staff.2. I understand that there is a risk of complications with every procedure, including the possibility of death as a severe complication of surgery, anesthesia, or other procedures. I also understand that there is no guarantee as to the results of any procedures, diagnostics, vaccines, or treatments. I understand that I may ask any questions that I have regarding any procedure, diagnostic, vaccination, or treatment recommended by Eco Planet Ltd T/A The Mobile Vet Company; veterinarian before it is performed.3. I authorize Eco Planet Ltd T/A The Mobile Vet Company to obtain all medical records regarding my pet from other veterinary hospitals as needed.4. I understand that Veterinary Technologists/Veterinary Technicians/Veterinary Nurses/Veterinary Assistants may perform certain functions in the preparation and care of my pet even when a veterinarian is not present5. I understand and agree that portions of my visit or the care and treatment of my pet may be recorded for security purposes.6. I understand that payment is due in full at the time that services are rendered. If for any reason payment is not made at the time services are rendered or within ten days after, I understand that my account may be referred to a collection agency. In the event that my account is referred to a collection agency, I agree that Eco Planet Ltd T/A The Mobile Vet Company may add an amount to my outstanding account balance to reimburse Eco Planet Ltd T/A The Mobile Vet Company for the reasonable collection charge imposed by the collection agency. Eco Planet Ltd T/A The Mobile Vet Company does not request or require personal information as a condition to payment by credit card, but card users may be required to provide proof of identity.7. Eco Planet Ltd T/A The Mobile Vet Company provides a mobile clinic for house call examinations and treatments to be performed in. If I request an examination and/or treatment be performed in my household Eco Planet Ltd T/A The Mobile Vet Company, its veterinarians, technicians, and assistants are not responsible for damage to property or personal items which may occur during the course of said visit.8. Professional restraint will always be provided by Eco Planet Ltd T/A The Mobile Vet Company veterinarians, technicians, and assistants. If I refuse the professional restraint of my pet provided, Eco Planet Ltd T/A The Mobile Vet Company and its veterinarians, technicians, and assistants are not responsible should I be injured by my pet.9. I understand that there is a risk of reaction with any vaccination. Vaccination reaction symptoms can range from mild to severe anaphylaxis or even death. If my pet requires emergency treatment for a vaccine reaction I authorize Eco Planet Ltd T/A The Mobile Vet Company to provide medical care and treatment they deem necessary and understand that I am responsible for the cost of said emergency care and treatment. **PLEASE NOTE: Due to the nature of our business operation, the Mobile/Booking Fees for missed (including missing pets and pet guardians), late, cancelled or rescheduled appointments will be billed as a cancellation fee of $50. Please ensure you and your pet are present for your confirmed appointment. 24 hours required.Signature*This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.CommentsThis field is for validation purposes and should be left unchanged.
