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Your name *

Pet’s name

My pet is a *

Cat

Dog

Other

Your email *

Pet’s breed *

Please specify if it's not a dog or cat

Your city, country

Pet’s date of birth (dd.mm.yyyy) *

Pet’s sex *

Male

Female

Pet’s weight (kg) *

Actual diet: please list all the ingrediens with precise designations and daily amounts (gram/day) *

Health: please list all the diagnoses

Your consent *

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