Photography Consent Form

In our ongoing efforts to provide you with the best possible service, we ask that you carefully review this consent form and ask any questions necessary to help you fully understand it. Please sign at the bottom only after careful review and consideration. For your consideration, I, the undersigned, hereby give ABA and its clients or agents permission for use of the photographs that they have taken of me.

• To copyright the same in their name or any other name that they may choose.
• To use and publish the same in whole or in part, individually or in conjunction with other photographs, in any medium for any purpose, including art, illustration, promotion, advertising or trade.
• It is understood that the use of the photographs is for illustrating a medical procedure and demonstration of treatment outcomes, including, but not limited to:
• Photo Book
• Website or Social Media Sites
• TV Broadcast
• Digital/Print Article or Publication
• Advertisement
• It is also understood that the use of the photographs used by ABA will be used in a way to protect patient identity, including, but not limited to facial procedures.

I hereby release ABA and its agents from any and all claims and demands arising out of, or in conjunction with, the use of the photographs.

I am of legal age.

I have read the foregoing fully and understand its contents.