I hereby acknowledge that I have been advised that photographs and images will be taken of me or my child, beforehand, during, and after procedures. The photographs will be taken by one of the members of our office. I hereby acknowledge that photographs may be taken during my, or my child’s, time in our office. I hereby give my consent for this office to use the photographs under the following circumstances: lectures, research, publications, internet advertising, on our website, on our social media outlets, or in any print advertising.
I grant this office and its employees, legal representatives, and associates the irrevocable and unrestricted right to use and publish photographs or video footage of me, or imagery in which I may be included, for editorial, trade, advertising, and web use. I also grant this office the right to alter any images or photographs without restriction and without my inspection or approval. I hereby release this office and their legal representatives from all claims and liability relating to said imagery.