Veterinary Client Record Copy Request Form
Request a copy of your pet's veterinary records. Please complete all sections to ensure accurate and timely processing.
Pet Owner's Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pet's Name
*
Pet's Species
*
Please Select
Dog
Cat
Bird
Reptile
Small Mammal
Other
Which records are you requesting?
*
Complete Medical History
Vaccination Records
Lab Results
Surgical Reports
Other (please specify)
Preferred Method to Receive Records
*
Email (PDF)
Pick Up at Clinic
Fax
Other
Reason for Request (optional)
Submit Request
Should be Empty: