Get New Clients Request For Records Form - Princeton Animal Hospital

Filling out the New Clients Request For Records Form for Princeton Animal Hospital is a straightforward process that ensures your pet's medical records are retrieved efficiently. This guide will walk you through each step to complete the form correctly, making the process smooth and easy.

Follow the steps to efficiently fill out the New Clients Request For Records Form.

1. Click the ‘Get Form’ button to access the New Clients Request For Records Form. This action opens the document in a viewer for you to complete.
2. Begin by entering the name of your pet in the designated field labeled 'Pet(s) Name.' This information is essential for identifying the medical records to be released.
3. Next, you will provide the details of the individual or business you are authorizing to receive your pet's medical records. Start with the first section by writing the name of the company or person in the 'Company Name' field.
4. Fill in the complete street address of the authorized recipient using the 'Street Address' line, followed by the 'City,' 'State,' and 'Zip' code fields.
5. If there are multiple recipients, repeat steps 3 and 4 to add additional company names and their corresponding addresses.
6. You have the option to authorize the release of medical records to any township requesting licensing information. To do this, initial the blank line provided if you agree to this authorization.
7. You also have the possibility to authorize the release of medical records to adoption agencies. If you choose to allow this, please initial the designated area.
8. Lastly, ensure that the form is signed by you, the owner, in the section labeled 'Signature of Owner,' followed by the date of signing in the 'Date' section.
9. Once you have completed all fields and added your signature, you can save the document, download it for your records, print it, or share it as needed.

Make sure to complete the New Clients Request For Records Form online today for a hassle-free experience.