Page 4 of 6
7.1 Name of usual veterinary surgeon
7.2 Company name
7.4 Telephone number
7.5 Email address
Do you have an emergency key holder?
8.5 Daytime telephone number
8.6 Evening/other telephone number
8.8 Add another person? Yes No If no, go to 9.1
8.13 Evening/other telephone number
8.14 Email address
Public liability insurance
9.1 Do you have public liability insurance? Yes No If no, go to question 7.6
If yes, please provide details of the policy
9.2 Insurance company
9.3 Policy number
9.4 Period of cover
9.5 Amount of cover (£m)
Please state what steps you are taking to
obtain such insurance
Disqualifications and convictions
Has the applicant, or any person who will have control or management of the establishment, ever been
Keeping a pet shop?
Keeping a dog?
Keeping an animal boarding establishment?
Keeping a riding establishment?
Having custody of animals?
Has the applicant, or any person who will have control or
management of the establishment, been convicted of any
offences under the Animal Welfare Act 2006?