Medical Records Request

Medical Records Requests

Please use the following contact form to request your medical records. Under normal circumstances and to ensure adequate transfer of patient care, the records are sent directly to the veterinary clinic who will be taking care of your pet moving forward. Please provide their information in the appropriate boxes below.

* Indicates required field

Your Name (Name We Have On File At Our Hospital) *

First

Last

Your Email On File At Our Hospital *

Phone Number (Primary Account Holder) *

Pet's Name (One Pet At A Time) *

I Am Transferring Records To: *

Transfer Care (Permanently) To Another Vet Transfer Care (Temporarily) To Another Vet Transfer Care To Specialist Office Other (Please notate in comment box below)

Other Veterinarian's Office Name *

Other Veterinarian's Email Address *

Please Note That Medical Records Requests Are Processed in the Order They Are Received *

I Understand & Acknowledge Records Que

Comments and/or Records Request Notes: *

SEND MEDICAL RECORDS REQUEST

EMAIL ADDRESS

[email protected]

TELEPHONE NUMBER

(714) 551-9911 (Office)
(714) 551-9498 (FAX)

PHYSICAL ADDRESS

University Veterinary Center
1716 West Glenoaks Ave
Anaheim, CA 92801