I understand my name, likeness and details of my testimonial of Apple Healthcare Group may be used in connection with publicizing and promoting the practice. I authorize The Practice to use my name, brief biographical information, and the Testimonial as defined on this form. I hereby irrevocably authorize The Practice to copy, exhibit, publish or distribute the Testimonial for purposes of publicizing The Practice’s services or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media. I agree that I will make no monetary or other claim against The Practice for the use of the statement. In addition, I waive any right to inspect or approve the finished product, including written copy, wherein my testimonial appears. I have read the authorization and release information and give my consent for the use and disclosure of my information as indicated above.