Medical Records Release Form

I hereby authorize the Peace Arch Veterinary Hospital to release my pet’s medical records to

First Name

Last Name

Pet Name

Species

Phone number on file

I hereby certify that I am the owner (Pet Parent) or authorized agent of the Pet Parent of the above described pet(s). Further, I hereby request and authorize this veterinarian to release the requested medical information for my pet(s). I release the veterinarian and staff from any legal responsibility or liability for the release of information to the extent indicated as authorized herein.*

Contact Info:

+1 (604) 536-3131
+1 (604) 536-3658
peacearchvet@gmail.com

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Locate Us at:

124-1959 152 ST, SURREY, BC, V4A9E3, Canada

Opening Hours :

M/T/W/T: 8:00am – 9:00pm
Friday: 8:00am – 7:00pm
Sat & Sun: 8:00am – 5:00pm

Vet appointments:

Mon-Fri: 9:00am – 7:00pm
Sat-Sun: 9:00am – 2:00pm

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