Please Review Our Legal Agreement
I hereby authorize my testimonial to be used for testimonial advertisement in Brain, Spine & Vascular Neuroscience Institute’s promotional material, including Brain, Spine & Vascular Neuroscience Institute’s website, brochures, and advertisements. I waive the right of prior approval and hereby release and discharge Brain, Spine & Vascular Neuroscience Institute and all persons acting under the permission and authority of Brain, Spine & Vascular Neuroscience Institute 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.

