Release of Medical Records

  • The person(s) named above authorize information of all pet(s) vaccine and medical information to be requested or released by representatives of Redwood Veterinary Hospital Inc.

    • Referral / transfer to UC Davis or Specialty/Emergency Facility - All information/communication/images regarding assessment, diagnosis and treatment of pets’ condition, concern, or disease.

    • Other Veterinary Hospitals - Copy of complete medical/immunization record.

    • Pet Medical Insurance - All information/communication regarding assessment, diagnosis and treatment of pets condition, concern or disease.

    • Boarding Facilities - All information regarding immunizations.

    • Grooming Facilities - All information regarding immunizations.

    Please note: Unless otherwise specified by law, we will release only the information which has been created by Redwood Veterinary Hospital Inc., including chart notes, lab results, summaries, and consultation reports. Records created by and available from other providers, hospitals, or other care facilities must be obtained directly from those other providers or facilities.

    The information you are authorizing to be released could be re-released or disclosed by the recipient. Such additional disclosures or releases may not be prohibited by law. We are not responsible for the actions of others who may be provided with information released because of this authorization.

    **We will happily transfer copies of your pet(s) records directly to the above facilities at no charge to you. However, a fee will be charged for additional copies requested for personal use.
  • Date Format: MM slash DD slash YYYY