Animal Care App Data Consent
Please review and provide your consent for the collection and use of your and your animal's data via our mobile app.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Animal Information
*
Please review the following data usage consent agreement. By agreeing, you allow the Animal Care Mobile App to collect, store, and process your and your animal's information for the purpose of providing veterinary and animal care services. Your data will be handled securely and will not be shared with third parties without your permission, except as required by law.
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature (please sign below to confirm your consent)
*
Submit Consent
Submit Consent
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