Veterinary Ireland

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Mobile

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Text

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Phone

Practice information
The practice information needs to be completed if you have given us consent to contact.

* Indicates required field

Business Name *

Address *

Eir Code *

Phone Number *

Office Email Address *

Fax *

Contact Name *

Website *

Staffing details

No. of Qualified Partners *

Approximate annual wageroll *

Full Time

No. of Qualified *

No. of Trainees *

Veterinary Nurses *

No of Other Staff *

Approximate annual wageroll *

Part Time

No. of Qualified *

No. of Trainees *

Veterinary Nurses *

No of Other Staff *

Approximate annual wageroll *

Premises

Nature of work carried out

Domestic Pets

% of overall turnover *

Max Val any one animal € *

Livestock

% of overall turnover *

Max Val any one animal € *

Bloodstock

% of overall turnover *

Max Val any one animal € *

Equine

% of overall turnover *

Max Val any one animal € *

Greyhounds

% of overall turnover *

Max Val any one animal € *

Other –

Please specify *

% of overall turnover *

Max Val any one animal € *

Please complete if you work with Herds

Dairy Cattle

No. of herds *

Avg. herd size *

Max herd size *

Beef Cattle

No. of herds *

Avg herd size *

Max herd size *

Sheep

No. of herds *

Avg herd size *

Max herd size *

Pigs

No. of herds *

Avg herd size *

Max herd size *

Other

No. of herds *

Avg herd size *

Max herd size *

Other details
Does the practice carry out:

Equine Pre-Purchase Assessment *

Yes No

Estimated No.: *

TB testing *

Yes No

Estimated Turnover € *

Accident and Emergency Service *

Yes No

A & E services to other Practices *

Yes No

Current Professional Indemnity insurance details

Limit Any one claim € *

Aggregate limit € *

Excess € *

Claims Experience
Total Number of claims

No. Property claims *

Total Cost € *

No. Liability claims *

Total Cost € *

No. Prof. Indemnity claims *

Total Cost € *

Details of largest claims
Claim 1

Type of Claim *

Date *

Cost of Claim *

Cause *

Claim 2

Type of Claim *

Date *

Cost of Claim *

Cause *

Professional Indemnity

Renewal Date *

General Insurance

Renewal Date *

Submit

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Lir Insurance Limited is regulated by the Central Bank of Ireland.
Lir Insuranced Limited is a private company limited by shares registered in Ireland under number 552918 with registered office at Knockatee, Monilea, Mullingar, Co. Westmeath. The Directors are Dave Watkin and Judith Foley.

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Lir Insurance Limited is regulated by the Central Bank of Ireland.
Lir Insuranced Limited is a private company limited by shares registered in Ireland under number 552918 with registered office at Knockatee, Monilea, Mullingar, Co. Westmeath, N91 Y5R6, Ireland.