Customer Info

  1. Owner Name

     Mr.
     Ms.
     Mrs.
     Miss
  2. Address

  3. Contact

  4. :
    Email Regular Mail
  5. :
    English Français
  6. Yes No

Shelter Information

  1. If you are an adoption facility and you want to activate a trial policy, please visit the Petsecure Shelter Portal at www.adoptsecure.ca/portal and log in with your username and password. Should you need assistance obtaining this information then please email benefits@petsecure.com or call 1-800-431-3132 ext 7309. If you are a client, please contact our Customer Care Centre at 1-800-268-1169 for assistance.

Pet Info

  1. Breed

     Cat
     Dog
  2.  Male
     Female
  3. Date of Birth

  4. Microchip

Add another pet