A Program of the Central Pennsylvania Animal Alliance
	Medical Release Form   This form gives a representative from The Camp Hill Correctional Facility permission to have                                                                                                                                                                     Name of Dog  Treated at The Boiling Springs Animal Hospital located at 550 Park Drive, Boiling Springs, PA  17007  (717) 258-4575 during the following times:  Monday – Tuesday 8:00 am – 7:30 pm, Wednesday - Friday 8;00 am - 6:00 pm and on Saturdays from 9:00am – 1:00 pm.  Should this emergency arise after hours this form gives a representative from The Camp Hill Correctional Facility permission to have the above mentioned dog treated at the Animal Emergency Medical Center located at 11 Willow Mill Park Road, Mechanicsburg, PA  17050 (717) 796-2334.   ___________________________________________________________________________                                                                        Signature of Representative from Rescue   HOPE Program staff will contact the particular rescue.  Please list an emergency contact person for your rescue and all necessary phone numbers.  Please note that this person may be called at any time. Emergency Contact Name and Phone Numbers _______________________________________________________   Click here to return to the previous page.
	Hounds of Prison Education A Program of the Central Pennsylvania Animal Alliance