Heart of Georgia Animal Care Medical Record Release Form

To comply with the American Veterinary Medical Association’s Principles of veterinary medical ethics regarding medical records, Heart of Georgia Animal Care requires written consent by the owner to release summaries or copies of their pet’s medical records to another veterinary practice or interested party.

To facilitate this process, Heart of Georgia Animal Care requires that you please use this Medical Records Release Form when requesting summaries or copies of your pet’s medical records. Once all required fields are entered please press submit and we will receive your request at Heart of Georgia Animal Care, prepare and transfer your records, and then inactivate your account with our clinic.  Upon inactivation of your account we will suspend veterinary and pet lodging services along with vaccine and medication reminders via text/call/mail/email.

Digital medical records are computerized summaries of your visits and will be emailed to your or the veterinary practice of your choice at no charge.

    Client Records For:

    Pet Names:

    Records Sent To:

    Authorization:

    AVMA – GA

    Copies of patient records must be made available to the owner of the animal upon written request to the veterinarian who treated the animal or to the veterinarian facility where the treatment was provided. Such records must be made available within ten (10) business days from request. The veterinarian may charge a reasonable charge for the search, retrieval, duplication and, if applicable, mailing of the patient records.