Consent Form

  • Such use includes the display, distribution, publication, transmission or otherwise use ofphotographs, images and/or videos taken for use in materials that include, but may not belimited to, printed materials such as brochures, newsletters, videos, and digital images used onThe Piedmont Equine Practice, Inc.’s website and social media, such as Facebook.
  • Date Format: MM slash DD slash YYYY
  • Please return this form to The Piedmont Equine Practice, Inc. Please notify The Piedmont Equine Practice, Inc. in writing if you would like to withdraw your permission for the use of images at any time.If a copy of this signed form is not provided, please request a copy from The Piedmont Equine Practice, Inc.

Contact Us

4122 Zulla Road
The Plains, VA 20198

Phone: 540-364-4950
Fax: 540-364-4987

Phone: 540-364-4954

Location Hours for Equine
Monday8:00am – 5:00pm
Tuesday8:00am – 5:00pm
Wednesday8:00am – 5:00pm
Thursday8:00am – 5:00pm
Friday8:00am – 5:00pm

We are on call 24/7 for emergencies- please call 540-364-4950 anytime