Your experience matters and your voice can help someone else feel less defeated while facing overwhelming medical bills.

By submitting a short video, you're helping bring awareness to the medical debt crisis and showing others that there are real solutions.

You do not need to share personal medical details or private health information. Keep your story general and share only what feels comfortable.

As a thank-you, you'll receive a $50 appreciation Visa E-Gift Card once your video is submitted and approved.

Please review and sign the release below so we can include your story in Resolves awareness and education efforts.

1. Consent to Use My Video and Testimonial

I voluntarily agree to submit a video recording ("Testimonial") to Resolve Medical Bills ("Resolve"

By signing this form, I grant Resolve the irrevocable, perpetual, worldwide, royalty-free, and sublicensable right and license to:

• Use my video, voice, likeness, and statements 

• Share my story in marketing, awareness campaigns, educational materials, and social media

• Edit my video for length, clarity, or formatting (without changing the meaning of my words)

• Display my testimonial on Resolve's website, emails, ads, and digital or printed marketing 

 

I understand this participation is voluntary.

2. No Medical or Sensitive Information Required

Resolve has encouraged me not to share personal health information or private medical details. I choose what I share and may keep the story general.

3. Rights Granted

I grant Resolve:

• The right to use, reproduce, modify, distribute, display, perform, and create derivative works from my submitted video, including my voice, likeness, and statements, in all media now known or hereafter devised.

• The right to use my first name (or no name, if preferred) 

• Worldwide usage rights without time limitations

• Permission to use the Testimonial without additional approval

I understand and agree that the payment described in Section 5 constitutes full and complete consideration for all rights granted herein.

4. How Resolve May Use My Story

My video may be used to:

• Educate people about medical debt, billing issues, or financial aid

• Inspire those facing similar challenges

• Raise awareness about medical debt

• Demonstrate the value of advocacy and support 

  Resolve may share the Testimonial on:

• Social media (Instagram, TikTok, Facebook, YouTube, LinkedIn)

• Resolve's website and email communications

• Digital ads, presentations, or marketing materials

• Media, partner content, or public awareness campaigns

   

5. Compensation

I will receive a $50 thank-you e-gift card after my video has been submitted and approved.

 

6. Goodwill Policy

I may contact Resolve at any time to request that my Testimonial no longer be used in future materials.

Resolve will make commercially reasonable efforts to stop the future use of the Testimonial in materials created after the date of such request, understanding that all previously published content, print, and digital media cannot be fully retracted.

 

7. Release of Liability

I hereby release, acquit, and forever discharge Resolve, its agents, successors, and assigns from any and all claims, demands, causes of action, and liability, of any nature whatsoever, for any and all injuries, damages, or claims, including, but not limited to, claims for defamation, invasion of privacy, right of publicity, copyright infringement, or emotional distress, arising out of the use or publication of my Testimonial.

 

8. Confirmation

By signing below, I confirm that:

• I am at least 18 years old
• I am participating willingly
• The statements in my video are true to the best of my knowledge
• I understand and agree to the terms of this release form