Veterinary Eye Center, PLLC

3201 Bee Caves Rd, Ste 120, #160044
Austin, TX 78746

(512)255-8700

veteyecenter.com

Medical Record Request Form


Orange and White CatPlease contact the client or the veterinarian who referred the patient to Veterinary Eye Center for patient medical records.


Through December 10th 2024, Medical Records can be requested for a living patient established at Veterinary Eye Center PLLC and last examined after April 30th 2019 using the below form.  Please submit the form once.

ALLOW UP TO 10-15 BUSINESS DAYS FOR THE MEDICAL RECORDS TO BE SENT.

Medical records can be sent to the patient's owner or co-owner listed in our records.  Medical records can also be sent to the patient's veterinarian.  Thank you!

After December 10th, 2024, please contact the owner or referring veterinarian for patient records.  More information can be found at Medical Records.

Medical Records Request Form

Patient Information
Patient's Name (required)

When was the patient's last eye exam at VEC? Please enter date or year:

Patient Species (required)

Cat
Dog
Other


Owner's Name (required)
First Name (required)
Last Name (required)
Owner's Phone and Email (required)
Phone TypePhone Number (required)
Owner's E-Mail Address (required) :
Co-Owner's Name:
First Name
Last Name
Co-Owner's Phone and Email
Phone TypePhone Number
Co-Owner's E-Mail Address :
Where would you like the medical records sent? (required)

Owner's Email
Co-Owner's Email
Veterinarian's Email


Veterinarian and Hospital Information (needed if medical records to be sent to veterinarian)
Veterinary Hospital Name

Veterinarian's Name

Veterinarian's Phone and Email
Phone TypePhone Number
Veterinarian's E-Mail Address :

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Last updated November 12, 2024