Request for Records or Radiographs Check-In Online Request for Records Note: We will need personal contact before sending any medical information. Due to privacy regulations, we can only send medical information upon the request of the actual pet owner. Request for Records Name of Client Name of Pet Address PhoneEmail(Required) Date of Visit MM slash DD slash YYYY Family Vet Name of person requesting information if different from above.Name Address PhoneEmail Relationship to Client What do you want sent? (radiographs, records, etc.) Name of person or veterinarian where information is to be sent: Address, Email or Fax:
