WEBB'S HEALTH AND HOME CARE LLC
DISABILITY IS NOT AN INABILITY
Photo and Media Release Consent Form
Clients Full Name
Guardians Full Name if applicable
Date of Birth
/
Month
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Day
Year
Date
I give permission for Webb's Health and Home Care LLC to use photos/videos for the following (check all that apply)
Website
Social Media
Printed Materials
All of the Above
I understand that these images may be used publicly and waive any rights to inspect or approve the finished product.
Yes I agree
No I do NOT agree
Signature
Date of Consent
/
Month
/
Day
Year
Date
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