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Animal Care Center of Carters Creek
2690 Spring Meade Blvd
Columbia, TN 38401
(931) 489-9333
Dr. Hemmert ~ Dr. Corley ~ Dr. Reynolds
Name, address, phone number of your veterinarian:
*
🛈
The following animal(s) have been presented to Animal Care Center of Carters Creek for examination/treatment/boarding. The owners have requested and/or authorized the release of medical records for the following pets. Please forward a copy of the medical record/vaccination history for each animal listed as soon as possible:
Owner:
*
Address:
*
Telephone Number:
*
Please list all pets you authorize medical records to be released at this time:
*
Complete medical record?
Yes
Vaccination history only?
Yes
Owner's Signature:
*
clear
Date:
*
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Please forward the requested medical records to carterscreek@yahoo.com or fax to (931) 451-5018.
Thank you for your cooperation.