Photography Consent Form
Signature will be recorded later.
Date: 4/16/2024
We will be taking some pictures or videos during your treatment. Most of these pictures are used for planning, records and lab communication. They are also used to communicate with you about your teeth at different points during your treatment. If we decided to use your photos in any of our advertising, we will have you sign a seperate release form. . By signing this agreement, you are giving us your permission to take your photos, videos, etc..
Last Name:
Birthdate:
First Name:
Photography Consent Form