Fill out our online form or print, complete, sign, date, and mail the following Consent to Release Medical Records to: Allegheny Equine Veterinary Service. Fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.Under the Your Menu tab, click Request Medical Record. Fill out the fields on the form page, sign electronically, and submit. Org or print and bring them with you at the time of your appointment. These forms will be useful when filing required documents related to estates of deceased or incapacitated persons. I accept financial responsibility for the emergency care of the animal(s). The Chance's Spot Emergency Alert Card will let people know that in case of an emergency, you have pets who need care. 1. Gather necessary information regarding your dog and your details. Release of my records will be for the purpose stated on this form.