Photo Consent Form

* required field

Class I Dental Associates Photography Release

I hereby authorize Dr. Schmidt/Dr. Morris or his/her assistants to take photographs, slides, and/or videos of my face, jaws, mouth, and teeth.I understand that the photographs, slides, and/or videos will be used as a record of my care and may be used for case visualization and educational purposes in the dental office or on our office webpage.I further understand that if the photographs, slides, and/or videos are used in any publication or demonstration, my name or other identifying information will be kept confidential.I do not expect compensation, financial or otherwise, for the use of these photographs.