Authorization to Release Veterinary Medical Records (Groomer Pet Hotel Daycare)

(Veterinarian) to release the following Medical Information for the Patient in accordance with laws and regulations applicable to the release of Patient Medical records. (1 to 2 business day turnaround)

For any questions, concerns, or issues; please call (888) 458-8587.

I release the Veterinarian and staff members from any legal responsibility and liability or the release of information to the extent indicated as authorized herein.

This release of Veterinary Records is governed by statutory and regulatory provisions, see American Veterinary Medical Association Confidentiality and Patient records summary of provisions via this link: https://www.avma.org/Advocacy/StateandLocal/Pages?sr-confidentiality-patient-records.aspx. Note that State Veterinary Medical Boards have the authority to interpret and enforce provisions of veterinary practice acts. If you have a question about how a particular State Law Provision applies to individual circumstances in that state, please contact your state’s veterinary medical board which can be accessed here: https://www.avma.org/KB/Resources/Reference/Pages/... *