Online Form

Client and Patient Photo Consent Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Client and Patient Photo Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Client and Patient Photo Release Form

This release form grants Brookfield Animal Hospital, its legal representatives and successors, as well as any company or person acting with its permission, the right to use, reuse, and publish in any manner, the undersigned’s (here after referred to as the MODEL) image, voice and any video footage in which the Model appears. The use of these photographs, voice recordings or video footage may be used in whole or in part, modified or altered, for all of the Producer’s promotion, client education, and advertising needs including non-commercial or commercial displays, brochures, handouts, any kind of social media posts (including Facebook), blogs, website pages, and other Internet uses. I waive the right to inspect or approve the finished product or copy of any use of the images voice recordings or video footage discussed above. I forever release and discharge Brookfield Animal Hospital, its representatives, licensees, and successors all claims, actions, and demands arising out of the use of the above mentioned images, voice recordings, or video footage including any claims of invasion of privacy and libel. By signing below I agree: (1) that I have read the above and that any questions about its meaning have been answered and (2) that I voluntarily agree to this agreement. If I am signing for another person (for example, because they are underage), I acknowledge that I am 18 years of age or older and that I have the legal right to agree for the underaged individual.

Use this field to list the names and descriptions of your pets that we have permission to photograph and post online. For example: Rye, 8 y.o. German Shorthaired Pointer; Tabitha, 5 y.o. alley cat, etc.