I grant permission to GET HELP® and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me, or members of my family, for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release GET HELP® and its legal representatives for all claims and liability relating to said images or video. Furthermore, I grant permission to use my statements that were given during an interview  with or without my name, for the purpose of advertising and publicity without restriction. I waive my right to any compensation.

Upon sending this form, we will follow up by forwarding the release to the email indicated below. We will request you reply to the email and confirm your photo release. Your email confirmation will be accepted as your legal signature.