• Consent For Dental Photography

  • I, (the Patient), authorize Town Creek Family Dentistry, to take photographs, and/or videos of my face, jaws and teeth, before, during and after treatment. I consent to allow the photographs to be used for dental records, research and dental education including lectures, seminars, demonstrations, professional publications such as journals or books.

    These photos may also be used for marketing material including websites and social media.
  • I further understand that if the photographs and/or videos are used, I will not be compensated, financial or otherwise, for the use of these photographs.
  • Signature