Free · Unbranded · Front desk & billing
A one-page authorization for sending a pet’s records to another clinic, a specialist, an insurer, or the owner. It spells out exactly which records go where, by what method, and for how long the authorization lasts.
Unbranded: no logo or linksNo account neededPrint at 100% on US LetterUpdated
What’s on the form
Owner contact details and up to three pets covered by the request.
The receiving clinic, specialist, insurer or person, with contact details.
Complete record or specific parts: vaccinations, labs, imaging, exam notes, a date range.
Why the records are needed and how to send them: email, fax, mail, or pick-up.
Expiry, signature, and an office-use section recording who sent what, when.
Fill in online
Every line on the form is editable right here. When you’re done, print it or choose “Save as PDF” in the print dialog. Everything stays in your browser.
Click any line to type, or add your logo. Nothing is uploaded or saved.
Using it well
Radiograph reports and the original images are different things. Specialists usually need the images; say so on the form.
The office-use box protects you when a receiving clinic says it never arrived.
States differ on who may receive veterinary records and how quickly. Check your state board’s rules on confidentiality and release.
Printing, editing, and what the form does and doesn’t cover.
Many states treat veterinary records as confidential and require the owner’s consent before releasing them to third parties. Requirements vary by state, so check your state veterinary practice act.
Yes. An owner can fill it in online, print or save it, and send it to their current clinic to request a transfer to a new vet.
Until the date written on the form. If it’s left blank, practices commonly treat it as a one-time release.
Some practices charge for physical copies or image media. Check whether your state limits fees, and state your policy on the form if you charge.
2 pages, US Letter, portrait
A clean intake form for new clients: owner and emergency contacts, room for two pets, the previous clinic and a records-transfer authorization, reminder preferences, and the payment acknowledgment, all in one pass at the front desk.
1 page, US Letter, portrait
A one-page itemized estimate with low and high columns, totals, deposit, and an expiry date. Clients choose accept, decline, or a partial plan and sign, so the decision and the numbers are on the record together.
1 page, US Letter, portrait
A one-page vaccine history for a dog or cat: every vaccine with the product, lot number, next due date, and who gave it, plus a log for heartworm and parasite tests and prevention. Handy for boarding, groomers, daycare, and new vets.
A starting point, not legal or clinical advice. VetStack’s forms are general templates. Requirements for medical records, consent, and controlled substances vary by state and practice, so review the wording with your practice’s attorney and check your state veterinary board’s rules before adopting a form as standard.