Photo Consent Form

Please complete the form below.

I hereby grant Veterinary Behavior of Indiana and it’s staff members permission to use any photographs taken of myself or my pet, in any and all of its publications, including website blog and social media entries, without payment or any other consideration. I understand and agree that these materials will become your property and will not be returned. I hereby authorize Veterinary Behavior of Indiana to edit, alter, copy, exhibit, publish or distribute such photographs for purposes of publicizing your programs or for any other lawful purpose. *

I have read, understand, and agree.

In addition, I waive any right to royalties or other compensation arising or related to the use of any photographs taken by Veterinary Behavior of Indiana. In signing this consent, I give authorization to use my name and my pet’s name and information as printed below. *

I have read, understand, and agree.

Pet's Name

Owner's Name *

First

Last

E-mail *

Date *

Phone