Photo/Video Release Form
We are active on social media and enjoy sharing our patient's progress (with your permission). If not, no problem! Like our facebook pages and follow us on instagram.
Yes, I give my permission for my (or my child's) photograph and/or video to be used for advertising/informational purposes on the company's website and social media.
No, I do not give my permission for my (or my child's) photograph and/or video to be used.
Date of signature
Should be Empty: