Video Consent Form

I grant permission to the Animal Hospital of Lake Villa, it's employees and authorized representatives to take photographs and/or video of me and/or my pet(s), to copyright, use and publish the same in print and/or electronically. Animal Hospital of Lake Villa may also use and publish my story, including relevant information and history. I agree that the Animal Hospital of Lake Villa may use such photographs, videos or stories including me and/or my pet with or without his/her name and for any lawful purpose including but not limited to such purposes as social media, publicity, advertising, and other web content. I especially grant permission to use the above video and certify that I have watched it to its completion. I allow for Animal Hospital of Lake Villa to use this video on their website, social media platforms as needed and decided upon by the management team at Animal Hospital of Lake Villa.

Animal Hospital of Lake Villa
101 S. Milwaukee Ave.
Lake Villa, IL 60046

Phone: (847) 356-8387
Text: (847) 356-8387
Fax: (847) 558-2606

Premier Veterinary Group
Emergency: (847) 548-5300