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Add A Pet

Step 1 of 3 - You and Your Pet

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First Name*
Surname*
Email*

We will send your policy documents to this address
New Pet Name*
Date of Birth*
DD slash MM slash YYYY

If your pet is younger than 6 weeks old, please wait for them to grow a little before coming back to add them to your cover. All dogs between the ages of 8 & 9 and cats 9 years & over are subject to a complete vet history when joining Ultimate360° or Essential. All dogs over 9 years of age are offered Lite or Accident plans which have no age maximums, not Ultimate360° or Essential.
Cat or Dog*
- Dog
- Cat
Breed of Dog*
Breed of Cat*
Gender*
- Male
- Female
Is your pet sterilised? (Optional)
- Yes
- No
Policy No:*

This is your existing policy number for your current policy with MediPet.
Coupon Code
Cover option for your pet*
- Ultimate360°
- Essential
- Lite
- Accident
Ultimate360° : Worry-free, comprehensive cover for accidents, illness, holistic wellness, & additional benefits for complete peace-of-mind, within R65 000 annual maximum
Essential: Worry-free comprehensive cover for accidents, illness & holistic wellness, within R55 000 annual maximum
Lite: Limited, affordable accident & illness cover for all ages including pre-existing conditions (up to 4 claims a year, maximum R13 760 per claim) within R40 000 annual maximum
Accident: Basic, unforeseen accident cover, without waiting periods, within R25 000 annual maximum
Cover option for your pet*
- Ultimate360°
- Essential
- Lite
- Accident
Ultimate360°: Worry-free, comprehensive cover for accidents, illness, holistic wellness, & additional benefits for complete peace-of-mind, within R65 000 annual maximum
Essential: Worry-free comprehensive cover for accidents, illness & holistic wellness, within R55 000 annual maximum
Lite: Limited, affordable accident & illness cover for all ages including pre-existing conditions (up to 4 claims a year, maximum R13 760 per claim) within R40 000 annual maximum
Accident: Basic, unforeseen accident cover, without waiting periods, within R25 000 annual maximum
Cover option for your pet*
- Accident Only
- Lite
Accident Only: Basic, unforeseen accident cover geared towards our golden oldies.
Lite: Limited, affordable cover for accidents and illness.
Day-To-Day Optional Routine Care Add-Ons
- Routine Supreme : R195 pm per pet
  R3 300 per year preventative cover towards vaccinations, tick/flea & deworming, microchipping & sterilisation, grooming & nail-clipping, training & puppy socialisation
- Routine In-Between : R130 pm per pet
  R2 200 per year preventative cover towards vaccinations, tick/flea & deworming, microchipping & sterilisation, grooming & nail-clipping, training & puppy socialisation
- Routine Lean : R65 pm per pet
  R1 100 per year preventative cover towards vaccinations, tick/flea & deworming, microchipping & sterilisation, grooming & nail-clipping, training & puppy socialisation
Premium Saver
- R1 000 flat excess on all Lite, General, Specific & Dental claims, for 7.5% discount on premium
- R2 000 flat excess on all Lite, General, Specific & Dental claims, for 15% discount on premium
Has your pet been adopted or rescued within the last 6 months?*
- Yes
- No
Pets joining Essential or Ultimate360° plans over the age of 6 months at the time of adoption, and without a complete vet record, are temporarily offered cover limited to R3 000 for the first 6 months after joining. This would not apply in the case of an accident during this period.

You selected the Accident plan which means we do not require your pet's vet history.

Please click the Next to Vet Contact button below to continue.
You selected the Lite plan which means we do not require your pet's vet history.

Please click the Next to Vet Contact button below to continue.
Has your pet ever been to the vet for medical reasons?*
- Yes
- No
We do not require routine care visit histories. These include vaccinations, sterilisations, deworming, tick & flea control, microchipping, grooming & nail clipping, training & puppy socialisation.

Details of Visit

Approximate Date of Visit	Details of Visit to Vet	Has your pet fully recovered from this event?	Actions

There are no Entries.

Maximum number of entries reached.

Does your pet take any medication?*
- Yes
- No
Include any supplements and naturopathic/homeopathic substances.

Add information regarding Medication

Details of and reason for medication?	Has your pet fully recovered from the condition requiring medication?	Actions

There are no Entries.

Maximum number of entries reached.

Eye/Ear Conditions*
- Yes
- No

Add information regarding Eye/Ear Conditions

Date	Description of condition	Has your pet since fully recovered?	Actions

There are no Entries.

Maximum number of entries reached.

Lameness?*
- Yes
- No

Add information regarding Lameness

Date	Description of condition	Has your pet since fully recovered?	Actions

There are no Entries.

Maximum number of entries reached.

Vomiting/Diarrhoea?*
- Yes
- No

Add information regarding Vomiting/Diarrhoea

Date of visit?	Has your pet fully recovered?	Actions

There are no Entries.

Maximum number of entries reached.

Skin irritations or conditions?*
- Yes
- No

Add information regarding Skin Conditions

Date	Description of condition	Has your pet since fully recovered?	Actions

There are no Entries.

Maximum number of entries reached.

Any other diagnosed or treated conditions?*
- Yes
- No

Add information regarding any other diagnosed or treated conditions

Date	Description of condition	Has your pet since fully recovered?	Actions

There are no Entries.

Maximum number of entries reached.

Vet Contact

Vet Clinic or Hospital	Phone Number	Actions

There are no Entries.

Maximum number of entries reached.

Disclaimer*
- I accept that non-disclosure of any previous condition(s) may result in the cover being voided with immediate effect
- Please keep in touch with me. We won't send you anything unless we have something important to say.
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Unit 4
Silverwood Cl
Tokai
Cape Town
7945

info@medipet.co.za
021 701 2023

"MediPet" is brought to you by MediPet Animal Health Insurance Brokers (Pty) Ltd. (FSP Licence 32613)
& is underwritten by Renasa Insurance Company Ltd (FSP Licence 15491)

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Home
Plans
- View Plans
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MediPet Family
- Add A Pet To Your Cover
Why MediPet?
Blog
Contact Us
Get A Quote