Record Request Form

Record Request Form

Please complete the following form to request your pet's medical records. If we are sending them to a third party, we will copy you on the email. You should receive an email with the records within 1 business day.
Name*

First NameLast Name
Patient/s Name/s*
Your Email*
example@example.com
Email Where We Should Send Records (if applicable)
example@example.com
Please let us know why you are requesting records as it helps us keep our database current. Inactive patients can always be reactivated at any time.
I need records for the following:*

For Referral VeterinarianFor Pet InsuranceMoving Out of the AreaChanging Primary Care VeterinariansFor My Own RecordsFor Grooming/Daycare/Boarding
Should be Empty: