Southwest Veterinary Surgical Service, PC

Photographic Consent and Release Form

I hereby authorize Southwest Veterinary Surgical Service, PC and those acting in pursuant to its authority to:

  • (a) Record to my pets’ likeness on video, audio, photographic, digital, electronic or any other medium.
  • (b) Use my pets’ first name in connection with these recordings.
  • (c) Use, reproduce, exhibit or distribute in any medium (e.g. print publications, video tapes, CD-ROM, Internet/WWW) these recordings for any purpose that Southwest Veterinary Surgical Service, and those acting to its authority, deem appropriate, including promotional or advertising efforts.