Step 1 of 2

  • Date Format: DD slash MM slash YYYY
  • £ 0.00
    • Horse 1

    • Date Format: DD slash MM slash YYYY
    • *See practice leaflet.
    • Horse 1 monthly Direct Debit

    • Horse 2

    • Date Format: DD slash MM slash YYYY
    • *See practice leaflet.
    • Horse 2 monthly Direct Debit (including £1 multi pet discount)

    • Horse 3

    • Date Format: DD slash MM slash YYYY
    • *See practice leaflet.
    • Horse 3 monthly Direct Debit (including £1 multi pet discount)

    These are dependent on sign-up date.
  • I have read and understood the terms and conditions overleaf and acknowledge that they form part of this agreement, in particular, we would like to draw your attention to Clause 3 – Your membership of MiHealthyPet Club is for an initial term of one year and shall continue thereafter until such a time as it is terminated by you or the veterinary practice, in accordance with Clause 4.

    All correspondence about this health plan will be provided by email to the address supplied above. Please keep TVP & MHP informed of any changes to your email address. 

  • Date Format: MM slash DD slash YYYY
  • Instruction to your bank or building society to pay by Direct Debit

  • Please fill in the whole form using a ball point pen and send to:
    MiVetClub Limited, CVS House, Owen Road, Diss, Norfolk IP22 4ER

    Name and full postal address of your bank or building society



  • Instruction to your bank or building society

    Please pay MiVetClub Limited Direct Debits from the account detailed in this
    Instruction subject to the safeguards assured by the Direct Debit Guarantee.
    I understand that this Instruction may remain with MiVetClub Limited and, if so, details will be passed electronically to my bank/building society.

  • Date Format: DD slash MM slash YYYY
    Banks and building societies may not accept Direct Debit Instructions for some types of account.
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