{"id":4162,"date":"2022-12-21T10:00:42","date_gmt":"2022-12-21T14:00:42","guid":{"rendered":"https:\/\/chuv.umontreal.ca\/english\/?page_id=4162"},"modified":"2025-02-03T11:20:17","modified_gmt":"2025-02-03T15:20:17","slug":"photo-and-video-consentement-form","status":"publish","type":"page","link":"https:\/\/chuv.umontreal.ca\/english\/photo-and-video-consentement-form\/","title":{"rendered":"Photo and Video Consentement Form"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume\" id=\"wpforms-4158\"><form id=\"wpforms-form-4158\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"4158\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/english\/wp-json\/wp\/v2\/pages\/4162\" data-token=\"91607f99f14f5a0595dffd7a52f0c4c3\" data-token-time=\"1778039887\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-4158-field_5-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"5\"><div id=\"wpforms-4158-field_5\" class=\"wpforms-field-large wpforms-field-row\"><p>Whereas the Faculty of Veterinary Medicine (FMV) and the Centre hospitalier universitaire v\u00e9t\u00e9rinaire (CHUV) are an integral part of the Universit\u00e9 de Montr\u00e9al and are institutions of education, research and animal care.<\/p>\n<p>Whereas your image and the image of your animal belong to you, we ask that you consent to photos, images or videos be taken of you, or your animal, during the period of care.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-4158-field_2-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"2\"><label class=\"wpforms-field-label\">I consent free of charge and for an indefinite period of time, to the photographs, images and sounds of \u2026 <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4158-field_2\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4158-field_2_1\" name=\"wpforms[fields][2][]\" value=\"My Person\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4158-field_2_1\">My Person<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4158-field_2_2\" name=\"wpforms[fields][2][]\" value=\"My Pet\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4158-field_2_2\">My Pet<\/label><\/li><\/ul><\/div><div id=\"wpforms-4158-field_3-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"3\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_3\">Pet name<\/label><input type=\"text\" id=\"wpforms-4158-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" ><\/div><div id=\"wpforms-4158-field_4-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"4\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_4\">Species<\/label><input type=\"text\" id=\"wpforms-4158-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-4158-field_1-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"1\"><div id=\"wpforms-4158-field_1\" class=\"wpforms-field-large wpforms-field-row\"><p>May be captured and used anonymously (or with the names if I specifically authorize it) by the Universit\u00e9 de Montr\u00e9al or any person authorized by it, for the purposes of promoting education, research or advertising, on any medium it deems useful and for all current or future means of dissemination including, but not limited to publication, exhibition, television broadcasting and the Internet.<\/p>\n<p>I acknowledge that the material produced will be the exclusive property of the Universit\u00e9 de Montr\u00e9al.<\/p>\n<p>I may at any time terminate my consent with a written notice addressed to the attention of the CHUV at <a href=\"mailto:communications@chuv.umontreal.ca\">communications@chuv.umontreal.ca<\/a>, however, this decision will apply future use of the material.<\/p>\n<p>The FMV and the CHUV assures that any editing of the images and sounds do not contain any confidential information concerning the person or animal, unless explicitly otherwise agreed.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-4158-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_6\">First name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-4158-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" required><\/div><div id=\"wpforms-4158-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_7\">Last name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-4158-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" required><\/div><div id=\"wpforms-4158-field_8-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_8\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4158-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-4158-field_9-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-4158-field_9\">Signature<\/label><input type=\"text\" id=\"wpforms-4158-field_9\" class=\"wpforms-signature-input wpforms-screen-reader-element\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][9]\" autocomplete=\"off\" inputmode=\"none\" ><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-4158-field_9-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear Signature\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 19 46l90 90q19 19 46 19q26 0 45-19l181-181l181 181q19 19 45 19q27 0 46-19l90-90q19-19 19-46zm387-226q0 209-103 385.5T1153.5 1433T768 1536t-385.5-103T103 1153.5T0 768t103-385.5T382.5 103T768 0t385.5 103T1433 382.5T1536 768z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t\t<div class=\"wpforms-signature-clear-caption\">Clear Signature<\/div>\n\t\t\t<\/div><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"4158\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/chuv.umontreal.ca\/english\/wp-json\/wp\/v2\/pages\/4162\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-4158\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/chuv.umontreal.ca\/english\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>Please enable JavaScript in your browser to complete this form.Whereas the Faculty of Veterinary Medicine (FMV) and the Centre hospitalier universitaire v\u00e9t\u00e9rinaire (CHUV) are an integral part of the Universit\u00e9 de Montr\u00e9al and are institutions of education, research and animal care. Whereas your image and the image of your animal belong to you, we ask&hellip;<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4162","page","type-page","status-publish","hentry","description-off"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Photo and Video Consentement Form - Internet English<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/chuv.umontreal.ca\/english\/photo-and-video-consentement-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Photo and Video Consentement Form - Internet English\" \/>\n<meta property=\"og:url\" content=\"https:\/\/chuv.umontreal.ca\/english\/photo-and-video-consentement-form\/\" \/>\n<meta property=\"og:site_name\" content=\"Internet English\" \/>\n<meta property=\"article:modified_time\" content=\"2025-02-03T15:20:17+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/chuv.umontreal.ca\\\/english\\\/photo-and-video-consentement-form\\\/\",\"url\":\"https:\\\/\\\/chuv.umontreal.ca\\\/english\\\/photo-and-video-consentement-form\\\/\",\"name\":\"Photo and Video Consentement Form - 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