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Release of Medical Records Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.
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Release of Medical Records Form

Release of Medical Records Form

Please release a copy of all veterinary records, including (but not limited to):

1. A detailed history for the last 2 years including vaccines, examinations, notes, radiographs/reports and laboratory diagnostics.
2. Vaccination Reminder Reports
3. Previous Medical History
Clear Signature
(Must be 18 years or older)