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Home
Our Hospital
Our Doctors
Our Team
Forms
Hospital Tour
Careers
AAHA Accredited
Payment Options
Client Education
Canine Education
PETDESK
Services
Laser Therapy
Cruciate Disease
Dental Care
View All Services
New Clients
New Patient Registration
Pharmacy
Contact Us
Make An Appointment
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Social Media Authorization Form
Social Media Authorization Form
"
*
" indicates required fields
First Name
*
Last Name
*
Consent Choice
I, as named above, hereby authorize Dunckel Veterinary Hospital to use photos and/or other likenesses of my pet(s), for whom I have legal ownership of, for any promotional materials, programs, or services. Such likeness may not be sold or distributed to other parties. However, promotional material bearing such likeness may be distributed for free to the public via Dunckel Veterinary Hospital’s social media platforms such as: website, Facebook, Instagram, TikTok, etc. Dunckel Veterinary Hospital reserves the right to use any photo or likeness for a period of time beginning when this form is signed and ending upon the written (or verbal) request of participant.
Please Make a choice
*
Yes, use my pet(s) pictures!
No, I do not authorize Dunckel Veterinary Hospital to use my pet(s) pictures or their likeness
Client Signature
*
Date
*
MM slash DD slash YYYY
Printed Name
*
Email
This field is for validation purposes and should be left unchanged.
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