Request for medical records

Request for medical records

Bytown Cat Hospital (422 McArthur Ave., Ottawa, ON K1K 1G6) Merivale Cat Hospital (1038 Merivale Rd., Ottawa, ON K1Z 6A7)
You may wish to have a copy of your cat's medical record for various reasons, such as for a pet insurance company, for another veterinary hospital (if you move), or for your own files. Please fill out this short form to initiate your request.

By using this form, you are helping us protect your privacy and streamline the process. It also allows us waive the charge for providing copies.

In most cases, we can provide a copy within three business days.
- Date*
  
  MonthDayYear
  Date
- BytownMerivale
- Your name*
  
  First NameLast Name
- Your email address*
  example@example.com
- Please let us know which cat(s) medical records to send
- Your first cat's name*
- Your second cat's name
- Your third cat's name
- Your fourth cat's name
- I am movingI want a clinic closer to homeI had a bad experience with your hospitalFor insurance purposesMy cat is having surgery elsewhereMy cat is having dentistry elsewhereMy cat was referred to a specialistMy cat is boarding elsewhereMy cat is having radioiodine treatmentI would like to use a housecall/mobile vetMy cat is going to a new homeMy groomer wants proof of vaccinationI want the records for my own filesOther
- To another veterinary clinicTo meTo Trupanion insurance companyTo another insurance companyOther
- YesNo
- Please provide the email address the medical record should be sent to.*
- We can send the medical record to the veterinary clinic for you if you enter the email address below.
  Email address
- YesNo
- YesNo
- Under the Personal Information Protection and Electronic Documents Act and the Veterinarians Act only the legal owner or an authorized representative can consent to release of medical records.
- YesNo
- Signature
- Should be Empty:

Request for medical records

Please let us know which cat(s) medical records to send