Personal Information Policy/Media Consent Form

I understand that Lockerby Animal Hospital Inc. has a Personal Information Policy in accordance with the requirements of the Personal Information Protection and Electronic Documents Act. By signing below, I am consenting to the collection, use and disclosure of my personal information in accordance with purposes set you in the Policy, which include the following:
 

• Maintaining complete and accurate client files, and complying with the requirements of the College of Veterinarians of Ontario, the Veterinarians Act and regulations under the Act;
• Providing goods and services to veterianry clients, including contacting clients to schedule appointments and follow up on patient treatment, billing for goods and services and notifying clients about new services and promotional offers;  and
• Communicating and working with third parties not limited to those providing veterinary medical or other services to clients, including other veterinary facilities, insurance, medical record, webstore and communication companies.  

I understand that: 
 

• My personal information will not be used or disclosed for purposes other than those for which it was collected, except with my consent, or except where use or disclosure if required by law;
• I have the right to view my personal information and have it amended, if inaccurate or incomplete; and 
• A copy of the policy will be provided upon request.

I authorize Lockerby Animal Hospital to publish photographs/videos or any form of media of myself or my pet in print documents, videos, emails, websites or any form of media including but not limited to Facebook, Twitter, Google, Instagram, Pinterest, television etc. I understand that any photographs and video clips of me or my pet will remain on the Lockerby Animal Hospital website or social media sites at the discretion of the publishers. I understand that my pet will be identified by first name only.