Online Forms

Photo Consent Form

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

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A small brown dog joyfully running across a lush green grass

Photo Consent Form

Name(Required)
Home Address(Required)
Spouse Name(Required)
I understand that all payments are due upon services rendered(Required)
Clear Signature
MM slash DD slash YYYY
PLEASE FILL OUT EVERYTHING!
Client Name(Required)
I grant permission to Midland Animal Clinic and Hospital, its representatives, and employees to take photographs of my pet(s) for marketing and promotional purposes. I authorize Midland Animal Clinic and Hospital to copyright, use, and publish these photographs in both print and electronic formats.(Required)
Midland Animal Clinic and Hospital may take photographs of my pet(s) and use them, with or without a first name and last initial (e.g., Fluffy R.), for lawful purposes including social media, publicity, illustration, advertising, and website content. These photographs may be used in both print and electronic formats.(Required)
Clear Signature
Name(Required)
MM slash DD slash YYYY