Forms

Media Release Form

Authorize the Animal Center for Emergency and Specialty to use your pet’s photos, videos, and stories on social media.

Media Release Form

Your privacy and preferences are important to us. If you prefer not to have you or your pet photographed or recorded on video, please indicate your preferences below. We will respect and honor your wishes to ensure your comfort and privacy.

Purpose:

From time to time, a pet’s story is worth sharing to the world to help the public learn about certain dangers, diseases, injuries and the healing process. Sharing stories can help share awareness, as well as promote our services, to the community.

Promise:

With your authorization, we may use photos, video, non-identifying medical information and treatment outcomes in media releases to Facebook, Instagram, Twitter (X), or other social media. We promise to use this information responsibly and only in a positive light. Client retains the right to revoke authorization and posts will be removed at request.

We may, on occasion, use the same information in business deliverables (pamphlets, handouts, website pages or other). We will expressly inform the client of this intended use. Revocation of authorization in this instance will not be possible as it would be at great cost to ACES to remove these materials from circulation once printed.

I agree to allow ACES to use my pet, their likeness, and medical history in the manner described above.
I DO NOT allow ACES to use my pet, their likeness, and medical history in the manner described above.

Client Name *

First

Last

Client Email *

Patient Name *

Date *

Client Signature *

Clear Signature

Please note any situations in which photos/information is NOT to be used:

Message

Forms

Media Release Form

Media Release Form

Purpose:

Promise:

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