Photo Release Form

* Required Information

Please select all that apply: *

Good Shepherd Pet Hospital may take photos and/or videos of my pets

Good Shepherd Pet Hospital may take photos and/or videos of me

By selecting one or both of the above, you grant Good Shepherd Pet Hospital, its representatives, and employees the right to take photographs and/or videos of me and/or my pet, and to copyright, use, and publish the same in print and/or electronically.

You also agree that Good Shepherd Pet Hospital may use such photographs and/or videos of me and/or my pet with or without my name and for any lawful purpose, including, for example publicity, illustration, advertising, and web content.

If you prefer not to have you or your pet photographed or recorded on video, please select one or both of the options below: *

Good Shepherd Pet Hospital may NOT take photos and/or videos of my pets

Good Shepherd Pet Hospital may NOT take photos and/or videos of me

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