Medical Release - West Valley Humane Society

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help@westvalleyhumanesociety.org
208-455-5920

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Careers

Adopt
Intake Process
Lost & Found
Donate
- Donate
- Become a Sponsor
Foster
Veterinary Services
Resources
How to Help
Careers

Menu

Adopt
Intake Process
Lost & Found
Donate
- Donate
- Become a Sponsor
Foster
Veterinary Services
Resources
How to Help
Careers

Name of Owner *

First

Last

Any additional name that may be on record

First

Last

Email *

Phone *

Names and Species of Pets you a Requesting Medical Information For: *

Release the records to: *

How would you like the records sent? *

Email
Fax

Email to Send Records *

Email

Confirm Email

Fax # to Send Records *

Reason for Request *

I, the undersigned do hereby grant my permission for the release of any or all of the information contained in the medical records of the those pets listed above to the person or veterinary practice included in this form. Please sign below: *

West Valley Humane Society: Caring for animals, promoting adoption, and supporting responsible pet ownership throughout the Nampa and Caldwell, Idaho area.

Contact Us

(208) 455-5920
5801 Graye Ln., Caldwell, ID. 83607
Email Us

Hours (Appointment Only)

Tuesday - Saturday: 10:00 am - 6:00 pm (Scheduled Appointments Required)
Monday - Sunday: Closed

Contact Us

Hours (Appointment Only)

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