Medical Records Release Form START NOW 7 Medical Records Release Form Please enable JavaScript in your browser to complete this form.I, the undersigned, do hereby grant my permission for the release of any or all of the information contained in the medical records of those pets listed below to the following person or veterinary practice:Name *FirstLastEmail *PET NAME(S) FOR RELEASE OF MEDICAL RECORDSPet's Name *Pet's NamePet's NamePet's NameRelease RECORDS TO:Today's Date *Fax NumberEmailReason for Request of Records:Signature *Clear SignatureSubmit
