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For Cat Insurance
Pet Name
*
Pet Age
*
Select Pet Age
8 Weeks - 1 Year
2 Years
3 Years
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6 Years
7 Years
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10 Years
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*
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*
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Is/are the pet(s) sound and healthy?
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Share your reason for selecting 'No'?
*
Is your pet cat/dog vaccinated for rabies, distemper, hepatitis, adeno virus, leptospirosis, para-influenza, corona, and parvovirus?
Yes
No
Please provide the names of the vaccinations administered
*
* Image upload is optional. Ensure that each uploaded file is in JPG, JPEG, or PNG format and does not exceed 500 KB in size.
Pet Photo
(Front View)
Pet Photo
(Left Side View)
Pet Photo
(Right Side View)
Your Delivery Address
*
You will receive policy hard copy in this address within 3 working days of policy purchase inside Dhaka and within 7 working days outside Dhaka
Referral Code
(
Optional – Applicable Only if Purchased from a Pet Shop or Vet Clinic
)
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