{"id":24763,"date":"2026-07-13T12:26:42","date_gmt":"2026-07-13T12:26:42","guid":{"rendered":"https:\/\/meikovet.ch\/?page_id=24763"},"modified":"2026-07-14T14:16:09","modified_gmt":"2026-07-14T14:16:09","slug":"new-customer-form","status":"publish","type":"page","link":"https:\/\/meikovet.ch\/en\/new-customer-form\/","title":{"rendered":"New Customer Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"24763\" class=\"elementor elementor-24763 elementor-24762\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7a8ed717 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7a8ed717\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5534571b\" data-id=\"5534571b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a1e4d24 elementor-section-content-top elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a1e4d24\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-59006be\" data-id=\"59006be\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e154e1b elementor-widget elementor-widget-text-editor\" data-id=\"e154e1b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>New Customer Form<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35d6136 elementor-widget elementor-widget-text-editor\" data-id=\"35d6136\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"isSelectedEnd\" style=\"text-align: center;\">We would appreciate it if you could fill out and submit the new customer form online before your appointment.<\/p><p class=\"isSelectedEnd\" style=\"text-align: center;\"><strong>If you have not yet made an appointment, we recommend doing so before filling out the form.<\/strong><\/p><p style=\"text-align: center;\">This way, we will already have your information and can best prepare for your visit. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9bfef17 elementor-section-content-top elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9bfef17\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-b6d46c2\" data-id=\"b6d46c2\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-0040c23\" data-id=\"0040c23\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-367a264 contactFormContact elementor-widget elementor-widget-shortcode\" data-id=\"367a264\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_27' style='display:none'><div id='gf_27' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_27'  action='\/en\/wp-json\/wp\/v2\/pages\/24763#gf_27' data-formid='27' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_page_27_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_27' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_27_78\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_78'>Phone<\/label><div class='ginput_container'><input name='input_78' id='input_27_78' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_27_78'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li class=\"gfmc-column gfmc-column100 gfmc-row-1-column gfmc-row-1-col-1-of-1\"><ul class=\"flex-wrapper flex-wrapper-1\"><li id=\"field_27_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_13'>Select location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_27_13' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='MeikoVet Dietikon' >MeikoVet Dietikon<\/option><option value='MeikoVet Frauenfeld' >MeikoVet Frauenfeld<\/option><option value='MeikoVet Hinwil' >MeikoVet Hinwil<\/option><option value='MeikoVet Interlaken' >MeikoVet Interlaken<\/option><option value='MeikoVet Ittigen' >MeikoVet Ittigen<\/option><option value='MeikoVet Lenzburg' >MeikoVet Lenzburg<\/option><option value='MeikoVet Lyssach' >MeikoVet Lyssach<\/option><option value='MeikoVet Schaffhausen' >MeikoVet Schaffhausen<\/option><option value='MeikoVet St. Gallen' >MeikoVet St. Gallen<\/option><option value='MeikoVet Uster' >MeikoVet Uster<\/option><option value='MeikoVet Wohlen' >MeikoVet Wohlen<\/option><option value='MeikoVet Zollikon' >MeikoVet Zollikon<\/option><\/select><\/div><\/li><li id=\"field_27_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you already booked an appointment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_75'>\n\t\t\t<li class='gchoice gchoice_27_75_0'>\n\t\t\t\t<input name='input_75' type='radio' value='Yes'  id='choice_27_75_0'    \/>\n\t\t\t\t<label for='choice_27_75_0' id='label_27_75_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_75_1'>\n\t\t\t\t<input name='input_75' type='radio' value='No'  id='choice_27_75_1'    \/>\n\t\t\t\t<label for='choice_27_75_1' id='label_27_75_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_74\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_74'>When is the appointment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_74' id='input_27_74' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_27_74_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_27_74_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_27_74' class='gform_hidden' value='https:\/\/meikovet.ch\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_27_77\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >What time is the appointment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_27_77'>\n                            <input type='number' name='input_77[]' id='input_27_77_1' value=''  min='0' max='24' step='1'  placeholder='HH' aria-required='true'   \/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_27_77_1'>Hours<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' name='input_77[]' id='input_27_77_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_27_77_2'>Minutes<\/label>\n                        <\/div>\n                        \n                    <\/div><\/div><\/li><\/ul><\/li><li class=\"gfmc-column gfmc-column100 gfmc-row-2-column gfmc-row-2-col-1-of-1\"><ul class=\"flex-wrapper flex-wrapper-1\"><li id=\"field_27_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Personal details<\/h2><\/li><li id=\"field_27_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_38'>Last name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_27_38' type='text' value='' class='medium'    placeholder='Last name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_35'>First name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_27_35' type='text' value='' class='medium'    placeholder='First name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_4'>Street \/ No.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_27_4' type='text' value='' class='medium'    placeholder='Street \/ No.' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_37'>ZIP code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_27_37' type='text' value='' class='medium'    placeholder='ZIP code' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_36'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_27_36' type='text' value='' class='medium'    placeholder='City' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_6'>Phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_27_6' type='tel' value='' class='medium'  placeholder='Phone number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_70\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_70'>Additional phone number<\/label><div class='ginput_container ginput_container_phone'><input name='input_70' id='input_27_70' type='tel' value='' class='medium'  placeholder='Phone number'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_8\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_8'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_27_8'>We\u2019ll send vaccination reminders for your pet, payment receipts, useful info from our clinic, and information about promotions and events to this email address.\n\nIf you don\u2019t want this, please explicitly let us know at the clinic. <\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_27_8' type='email' value='' class='medium'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_27_8\" \/>\n                        <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_27_53' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_27_2' class='gform_page' data-js='page-field-id-53' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_27_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_27_66\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Pet details<\/h2><\/li><li id=\"field_27_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_2'>Pet name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_27_2' type='text' value='' class='medium'    placeholder='Pet name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Animal species<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_72'>\n\t\t\t<li class='gchoice gchoice_27_72_0'>\n\t\t\t\t<input name='input_72' type='radio' value='Dog'  id='choice_27_72_0'    \/>\n\t\t\t\t<label for='choice_27_72_0' id='label_27_72_0' class='gform-field-label gform-field-label--type-inline'>Dog<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_72_1'>\n\t\t\t\t<input name='input_72' type='radio' value='Cat'  id='choice_27_72_1'    \/>\n\t\t\t\t<label for='choice_27_72_1' id='label_27_72_1' class='gform-field-label gform-field-label--type-inline'>Cat<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_72_2'>\n\t\t\t\t<input name='input_72' type='radio' value='Guinea pig'  id='choice_27_72_2'    \/>\n\t\t\t\t<label for='choice_27_72_2' id='label_27_72_2' class='gform-field-label gform-field-label--type-inline'>Guinea pig<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_72_3'>\n\t\t\t\t<input name='input_72' type='radio' value='Rabbit'  id='choice_27_72_3'    \/>\n\t\t\t\t<label for='choice_27_72_3' id='label_27_72_3' class='gform-field-label gform-field-label--type-inline'>Rabbit<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_72_4'>\n\t\t\t\t<input name='input_72' type='radio' value='Hamster'  id='choice_27_72_4'    \/>\n\t\t\t\t<label for='choice_27_72_4' id='label_27_72_4' class='gform-field-label gform-field-label--type-inline'>Hamster<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_72_5'>\n\t\t\t\t<input name='input_72' type='radio' value='other pet'  id='choice_27_72_5'    \/>\n\t\t\t\t<label for='choice_27_72_5' id='label_27_72_5' class='gform-field-label gform-field-label--type-inline'>other pet<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_40'>What kind of pet do you have?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_27_40' type='text' value='' class='medium'    placeholder='Animal species' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_73\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_73'>Breed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_27_73' type='text' value='' class='medium'    placeholder='Breed' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_41'>Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_27_41' type='text' value='' class='medium'    placeholder='Color' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_45\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_27_45' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\">\n                                        <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_27_45_2_container'>\n                                            <input type='number' maxlength='2' name='input_45[]' id='input_27_45_2' value=''   aria-required='true'   placeholder='Day' min='1' max='31' step='1'\/>\n                                            <label for='input_27_45_2' class='gform-field-label gform-field-label--type-sub '>DD<\/label>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_27_45_1_container'>\n                                        <input type='number' maxlength='2' name='input_45[]' id='input_27_45_1' value=''   aria-required='true'   placeholder='Month' min='1' max='12' step='1'\/>\n                                        <label for='input_27_45_1' class='gform-field-label gform-field-label--type-sub '>MM<\/label>\n                                   <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_27_45_3_container'>\n                                        <input type='number' maxlength='4' name='input_45[]' id='input_27_45_3' value=''   aria-required='true'   placeholder='Year' min='1920' max='2027' step='1'\/>\n                                        <label for='input_27_45_3' class='gform-field-label gform-field-label--type-sub '>YYYY<\/label>\n                                   <\/div>\n                                <\/div><\/div><\/li><li id=\"field_27_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Sex<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_43'>\n\t\t\t<li class='gchoice gchoice_27_43_0'>\n\t\t\t\t<input name='input_43' type='radio' value='female'  id='choice_27_43_0'    \/>\n\t\t\t\t<label for='choice_27_43_0' id='label_27_43_0' class='gform-field-label gform-field-label--type-inline'>female<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_43_1'>\n\t\t\t\t<input name='input_43' type='radio' value='male'  id='choice_27_43_1'    \/>\n\t\t\t\t<label for='choice_27_43_1' id='label_27_43_1' class='gform-field-label gform-field-label--type-inline'>male<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Neutered\/spayed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_44'>\n\t\t\t<li class='gchoice gchoice_27_44_0'>\n\t\t\t\t<input name='input_44' type='radio' value='yes'  id='choice_27_44_0'    \/>\n\t\t\t\t<label for='choice_27_44_0' id='label_27_44_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_44_1'>\n\t\t\t\t<input name='input_44' type='radio' value='no'  id='choice_27_44_1'    \/>\n\t\t\t\t<label for='choice_27_44_1' id='label_27_44_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_46'>Microchip no.<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_27_46' type='text' value='' class='large'    placeholder='Microchip no.'  aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_27_54' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_27_54' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_27_3' class='gform_page' data-js='page-field-id-54' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_27_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_27_67\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">More pet details<\/h2><\/li><li id=\"field_27_11\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_11'>Known \/ previous illnesses<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_27_11' class='textarea large'    placeholder='Known \/ previous illnesses'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_27_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Pet insurance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_49'>\n\t\t\t<li class='gchoice gchoice_27_49_0'>\n\t\t\t\t<input name='input_49' type='radio' value='yes'  id='choice_27_49_0'    \/>\n\t\t\t\t<label for='choice_27_49_0' id='label_27_49_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_49_1'>\n\t\t\t\t<input name='input_49' type='radio' value='no'  id='choice_27_49_1'    \/>\n\t\t\t\t<label for='choice_27_49_1' id='label_27_49_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_50'>If yes, with which insurer<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_27_50' type='text' value='' class='large'    placeholder='Name of insurer'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you been abroad with your pet?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_27_48'>\n\t\t\t<li class='gchoice gchoice_27_48_0'>\n\t\t\t\t<input name='input_48' type='radio' value='yes'  id='choice_27_48_0'    \/>\n\t\t\t\t<label for='choice_27_48_0' id='label_27_48_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_27_48_1'>\n\t\t\t\t<input name='input_48' type='radio' value='no'  id='choice_27_48_1'    \/>\n\t\t\t\t<label for='choice_27_48_1' id='label_27_48_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_51'>Where were you abroad with your pet?<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_27_51' type='text' value='' class='large'    placeholder='Where abroad were you?'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_52'>When were you abroad with your pet?<\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_27_52' type='text' value='' class='large'    placeholder='When were you abroad?'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_55\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_55'>What food do you feed your pet?<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_27_55' type='text' value='' class='large'    placeholder='Food name, type of food, etc.'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_27_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_61'>Which veterinary practice was your pet previously treated at?<\/label><div class='gfield_description' id='gfield_description_27_61'>You can leave this question blank if your pet hasn\u2019t been treated at any other veterinary practice yet.<\/div><div class='ginput_container ginput_container_text'><input name='input_61' id='input_27_61' type='text' value='' class='large'  aria-describedby=\"gfield_description_27_61\"  placeholder='Name of the vet'  aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_27_57' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_27_57' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_27_4' class='gform_page' data-js='page-field-id-57' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_27_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_27_68\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">More details and consent<\/h2><\/li><li id=\"field_27_59\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >How did you hear about the MeikoVet clinic:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_27_59'><li class='gchoice gchoice_27_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='Recommendation from friends \/ acquaintances'  id='choice_27_59_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_1' id='label_27_59_1' class='gform-field-label gform-field-label--type-inline'>Recommendation from friends \/ acquaintances<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.2' type='checkbox'  value='Vets \/ breeders'  id='choice_27_59_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_2' id='label_27_59_2' class='gform-field-label gform-field-label--type-inline'>Vets \/ breeders<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.3' type='checkbox'  value='TV show \u00abTierisch\u00bb'  id='choice_27_59_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_3' id='label_27_59_3' class='gform-field-label gform-field-label--type-inline'>TV show \u00abTierisch\u00bb<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.4' type='checkbox'  value='Internet \/ Google'  id='choice_27_59_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_4' id='label_27_59_4' class='gform-field-label gform-field-label--type-inline'>Internet \/ Google<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.5' type='checkbox'  value='Social Media'  id='choice_27_59_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_5' id='label_27_59_5' class='gform-field-label gform-field-label--type-inline'>Social Media<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.6' type='checkbox'  value='Advertising \/ trade fair \/ event'  id='choice_27_59_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_6' id='label_27_59_6' class='gform-field-label gform-field-label--type-inline'>Advertising \/ trade fair \/ event<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.7' type='checkbox'  value='Meiko Heimtierbedarf AG shop'  id='choice_27_59_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_7' id='label_27_59_7' class='gform-field-label gform-field-label--type-inline'>Meiko Heimtierbedarf AG shop<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.8' type='checkbox'  value='Emergency ring'  id='choice_27_59_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_8' id='label_27_59_8' class='gform-field-label gform-field-label--type-inline'>Emergency ring<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_27_59_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.9' type='checkbox'  value='other'  id='choice_27_59_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_59_9' id='label_27_59_9' class='gform-field-label gform-field-label--type-inline'>other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_27_56\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Confirmation and consent:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_56.1' id='input_27_56_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_27_56\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_27_56_1' >I confirm that my details are complete and truthful. I have read the privacy policy and agree to its provisions. I also acknowledge that consultations not cancelled in time or missed may be charged, and that services provided must be paid for directly after treatment in cash or by card.<\/label><input type='hidden' name='input_56.2' value='I confirm that my details are complete and truthful. I have read the privacy policy and agree to its provisions. 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