Client Photo Release Form

Patient Photo Release Form
This form seeks for the consent for photographs to be taken by Shay Studio Aesthetics. By signing this form, the client affirms in the understanding that the images may be used for different purposes. Including but not limited to, marketing, social media + education.

By consenting to the release of images, you agree that you will not receive any form of compensation.

Your refusal to consent to the release of your photographs will not, in any way affect the care you will receive at Shay Studio 🖤

You may rescind your authorization to the release of the photographs by simply writing a request to Shay!
Do you authorize the use of Photographs by Shay in Studio (for reference and progress purposes):
Do you authorize the use of Photographs by Shay on social media:
Client Name
Signature of Client
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Patient Photo Release Form