Scribenote Consent Form

As part of our commitment to providing the best possible care for our customers and their pets,
Myrtle Grove Animal Hospital and any of its affiliated hospitals (collectively the
“Hospital”) may, with your consent, use an automated notetaking technology application
utilizing artificial intelligence (the “Application”) to record and transcribe notes from
conversations during veterinary appointments. This AI-powered scribe system assists our
veterinary team by recording and transcribing veterinary consultations to enhance the accuracy
and efficiency of your pet’s medical records. The veterinarian will then review, edit, and
finalize the medical records to ensure all adequate and accurate information is recorded and maintained.

Our use of the Application for veterinary appointments is purely optional, and we will record
notes of the appointment by traditional means if you do not wish to consent to the recording
and transcription of your voice. This policy explains how the Hospital collects, stores, uses,
and destroys any voice recordings and/or transcripts, which may constitute biometric
information in some jurisdictions, in compliance with applicable laws.

Collection and Usage of Personal Information

We may employ different vendors, such as Scribenote (provided by Scribenote, Inc.) or other
similar vendors (the “System Vendor”) to provide the Application used to record and transcribe
conversations between our veterinary staff and customers, with both parties’ consent, while
fulfilling our customers’ pet care needs.

We do not use or disclose any information outside of what is necessary to transcribe notes
relating to providing pet care, perform quality control review related to the treatment, and assert
or defend claims related to providing our services. The Hospital and its System Vendor will
not sell, lease, trade or otherwise profit from your information.

The Hospital and its System Vendor will not sell, lease, share, trade or otherwise profit from your information, but
may use anonymized information therefrom (“Information”) for medical insights for use by the Hospital.

Retention and Destruction of Your Information

The Transcriptions of veterinary visits are housed on affiliated or third-party cloud servers that are maintained and
secured by the affiliates of the Hospital or System Vendor, and accessible by the Hospital. The Hospital and its
System Vendors treat your information as confidential and exercise reasonable care to protect it from disclosure to
unauthorized third parties. The Transcriptions will only be retained by the Hospital for so long as necessary for the
Purpose and, in any event, for no longer than 30 days.

Your Information will be destroyed by the Hospital or its System Vendor when it is no longer needed for its original
purpose unless applicable law requires it to be maintained for a longer period.

ACKNOWLEDGMENT AND CONSENT:

By signing below, I acknowledge that I have
read the Hospital’s Acknowledgment and Consent, understand it, agree to abide by it and
voluntarily consent to the Hospital’s and/or its System Vendor’s recording, storage, use,
transcription, disclosure, and destruction in accordance with the purposes described above.