Records Release
Date
03
/
26
/
2025
Client/Owner Name:
Pet's Name:
Client/Owner Email
Client/Owner Contact Phone #
This pet's main location for treatment has been:
NAH Main St
NAH 39th Ave/Holistic
NAH Newberry
NAH Springhill
NAH Main St
The reason for this request is:
I am moving/have moved.
I'm getting a 2nd Opinion.
Required for travel/boarding
Other:
I am requesting that a full copy of my pet's medical records be:
Sent via Email
Sent via Fax
Hard copy pick up (We will call you when ready. Copying fees may apply.)
Mailed via U.S. Mail (I will be notified in advance of any fees I need to pay for copies/mailing)
I will PICK UP records to be at the following location:
NAH Main St
NAH 39th Ave
NAH Newberry
NAHolistic
Springhill
Please use this email, fax number, or U.S. Mailing address:
Additional comments, if needed:
Please allow 24 - 48 hour turnaround for records request processing.
I certify that I am the owner or authorized person of the pet listed above according to records on file with Newberry Animal Hospital or Newberry Animal Holistic & Wellness.
Signature of Pet Owner/Client:
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