Consent for File Release or Transfer Form

Welcome to Gateway Veterinary Services! We look forward to taking amazing care of your beloved pet. Please fill out the form below before your appointment so we can get to know you and your pet(s). We’re here to provide a calm, relaxing experience for your family.

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Clinic Address(Required)

Patient Information

As owner, or authorized agent of owner, I give permission to have all files for said animals to be forwarded to the company as required. Email is preferred to
Consent for Electronic Disclosure: This is to confirm the client's request and consent for the enclosed information, documents and/or other files and attachments to be provided to Gateway Veterinary Services Prof. Corp. for their use as needed, at the designated fax or email as provided. Gateway Veterinary Services Prof. Corp. retains a copy of this document for the client/patient records.(Required)
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