Contact Form

    Store Name:
    Store Address:
    Store Phone:

    Store Owner and Manager Information:
    Name Title Cell Email Include on email contact (YES or NO)
    Who is our main contact on decision making?
    Do you have a Contracted Vet?
    Contracted Vet Information: If you have more than 3 vet locations, please submit additional location details on a separate sheet

    Business Name
    Address
    Phone Number
    Email
    Vet Name
    Vet Phone Number (if different than business)
    Office Manager Name (If applicable)
    Office Manager Number (if different than business)
    Business Name
    Address
    Phone Number
    Email
    Vet Name
    Vet Phone Number (if different than business)
    Office Manager Name (If applicable)
    Office Manager Number (if different than business)
    Business Name
    Address
    Phone Number
    Email
    Vet Name
    Vet Phone Number (if different than business)
    Office Manager Name (If applicable)
    Office Manager Number (if different than business)

    If you do not have a contracted vet, please answer additional questions below:

    Do you have a vet that completes animal check ins at the store?
    If YES, please provide the following details:
    Vet Name:
    Frequency of Store Visits:
    If No, please note that your account manager will be discussing this in more detail
    Puppy Warranty and Kit Information:

    How many days does a customer have to go to veterinarian to validate the warranty?
    If your warranty requires customers to use your contracted vet, are there any exceptions?
    Do you offer any puppy for lifetime program?
    Do you provide a kit with the purchase of puppy?
    PLEASE INCLUDE ALL WARRANTIES, KIT DETAILS AND EXAMPLE PURCHASE RECEIPT WITH SUBMISSION OF THIS PAPERWORK
    Does your store have an attorney?
    Legal Counsel Details:
    Attorney Name
    Attorney Phone Number
    Attorney Email
    Insurance Details:
    Insurance Business Name
    Contact Name
    Contact Phone Number
    Contact Email
    Please note that per the agreement, store must have Solutions.pet listed as an additional insured (Please refer to agreement for additional details)
    PLEASE INCLUDE PROOF OF INSURANCE DESIGNATION WITH SUBMISSION OF THIS PAPERWORK
    Additional Pet Information:

    Do you sell other animals besides puppies?

    If Yes, please list animals below:

    Animal Type Do you include warranty with purchase Do you provide any additional products or kit with purchase
    PLEASE INCLUDE ALL WARRANTIES, KIT DETAILS AND EXAMPLE PURCHASE RECEIPT WITH SUBMISSION OF THIS PAPERWORK
    Where can we send a confirmation email that this form has been completed?



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