Veterinary Records Release


You, and any person associated with you, are hereby authorized to give to the Pug Rescue Network of Michigan or any representative or appointee thereof, any and all information which may be requested regarding the physical condition, and treatment rendered by you for any/all animals owned by me and if necessary, to allow them, or any veterinarian appointed by them, to examine any records which you may have regarding the condition or treatment of any/all animals owned by me. Also authorized is the release of any records or other information pertinent to or resulting from the physical condition of any/all animals owned by me. A copy of this authorization may serve instead of the original.

Please send up to two (2) years of vet records to

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