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I hereby authorize my testimonial to be used for testimonial advertisement in Cheyenne Orthopaedics, PC’s promotional material, including Cheyenne Orthopaedics, PC’s website, brochures, and advertisements. I waive the right of prior approval and hereby release and discharge Cheyenne Orthopaedics, PC and all persons acting under the permission and authority of Cheyenne Orthopaedics, PC from liability, damages, compensation or actions of any kind based on the use of my testimonial or information in the testimonial.
By signing above, I agree and acknowledge that I have read and understood the above Release and agree to all terms described. I am of legal age and freely sign this consent to release my patient testimonial.
