Home » 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*

Printed Name*

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.