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Get Claim Form For Veterinary Fees - Allianz - Allianz

Me Telephone: Mobile: Email: We will make cheques payable to the policyholder shown on your Schedule of insurance. Please indicate here if you require the cheque to be made payable to your veterinary practice Yes No If yes, please write the practice s name below. 2 About: Your pet - to be completed by policyholder(s) Your pet s name Male Breed Dog Female Cat If your pet has been seen at more than one veterinary practice, please provide details here. A. Name Address B. Name Addres.

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