Pre-Visit Questionnaire Form

Photo Release

I hereby grant Animal Hospital of Monticello permission to use my pet’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of Animal Hospital of Monticello and will not be returned. I hereby irrevocably authorize Animal Hospital of Monticello to edit, alter, copy, exhibit, publish or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my pet’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge Animal Hospital of Monticello from all claims, demands, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.