Consent To Transfer Medical RecordsConsent To Transfer Medical Records Download PDF Owner Name* Address* City* Province* Postal Code* Phone*Pet Information Pet Name* Species* Sex* Breed* Color* Age*I, (Owner Name)* the undersigned, do hereby authorize (Veterinary Hospital/Clinic)* to disclose and transfer my personal information and my pet(s) medical records to Sage Creek Animal Hospital. Signature of Pet Owner/Agent Name* Date*Note: Some Veterinary Hospital/Clinics charge a fee to transfer records, please follow up with the other Veterinary Hospital/Clinic to ensure your records are transferred quickly and efficientlyNote to Veterinary Hospital/Clinic: Please send complete Medical History and a Vaccine Certificate by Email (preferred) or Fax.Email: info@sagecreekanimalhospital.ca Fax: 204-255-1244 Δ