Beach Veterinary Clinic Records

Beach

Veterinary

Clinic

601 East Main Street

Beach, North Dakota

Appointments

Refills

Records

Submit records to our clinic

fax: (701) 872-3069

mail: Beach Veterinary Clinic

PO Box 130

Beach, ND 58621

Request medical records

from our clinic

call: (701) 872-4158

(701) 872-4969

(800) 221-1265 toll free

or fill out the form below

Note: The client on file will be contacted for permission prior to release of records.

Requester's Name Enter Name

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Requester's Phone Enter Phone

Client's Name or Enter Name

Patient's Name Enter Name

Same as Requester

Where/How Records are to be Sent Enter Location & Directions (i.e. ABC Vet Clinic, fax to 123-456-7890

Medical History

Vaccination Records

What are you requesting?

(check one or both)