Hours: 8:30 am - 6:30 pm, Wednesday - Saturday | 6225 42nd Ave. N., Minneapolis, MN 55422
Urgent Care Clinic
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Please Complete the Following to Request Your Pet’s Records!
Client/Patient Information
Pet's Name
(Required)
Owner's Name
(Required)
First
Last
Phone
(Required)
Email
Requestor's Information
Are you the owner on file with us?
(Required)
Yes
No: Clinic, Boarding Facility, Groomer, Other
No: Family Member or Authorized 3rd Party
Name
First
Last
Organization
Clinic Name, Boarding Facility Name, etc.
Phone
(Required)
Records Information
What part of the Medical Record are you Requesting?
(Required)
Full Medical Record
Vaccination Logs/Certificates
From a Specific Date/Time Frame
Please list specific dates
E-mail or Fax Number Where Records Should be Sent?
(Required)
Attention To:
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