Social Media Release Form

We love sharing photos and videos of our patients and their families on social media, print materials, advertising, and signage for the hospital. Please fill out this form to allow us to share your pet! 

Please Select all that apply:(Required)

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:
Name(Required)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.