Behavior Vets Media Release
Name
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First Name
Last Name
Pet's Name
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I hereby authorize Behavior Vets (a subsidiary of Veterinary Management Services, LLC) to use my pet's photo and/or information related to my pet's experiences with Behavior Vets. I grant permission to Behavior Vets and its' agents to reproduce the photographs or videos taken of me or my family members for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. My consent is freely given as a public service to Behavior Vets without expecting payment. I release Behavior Vets and their respective employees, from any and all liability which may arise from the use of such news media stories, promotional materials, written articles, videotape and/or photographs. I acknowledge that I am over the age of 18 and the legal guardian of the patient. I elect the following option:
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Please do NOT share any information
OK to share with an alias in place of my pet's name
OK to share with my real pet's name
Signature
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