I hereby authorize Amp Orthodontics & Kids Dental to take photographs, slides, and videos of my/my child’s teeth, jaws, and face before, during, and after treatment.
I understand that these materials will be used as part of my/my child’s treatment record and may also be used for:
- Communication with other healthcare professionals.
- Educational purposes, including dental journals, presentations, or lectures.
- Marketing and advertising purposes, including but not limited to website publications, printed materials, and social media platforms such as Facebook, Instagram, Twitter, TikTok, YouTube, Google, and similar platforms.
I further acknowledge that:
- Identifying information (e.g., first name only) may be used unless I specify otherwise below.
- I do not expect any financial or other compensation for the use of these materials.
- I may revoke this consent at any time by providing written notice to Amp Orthodontics & Kids Dental.