Records Release – Metro Cat Clinic

Request For Release of Medical Records / Information

If you are moving or wish to have your cat treated elsewhere, you must submit this form to have your cat’s medical forms sent.

Client Name

Client Email

Client Phone

I request that copies of the medical records and/or information pertaining to my cat(s) named:

be released to:

Practice Name or Shelter Name:

at Phone Number

Fax Number

Client Signature

Date