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www.dentsplysirona.com STEPPS™ Photography – Declaration of consent Practice Declaration of consent Please have all persons photographed sign here: "I give my consent that the photos on which I appear may be used for all communication activities of the practice above and for an unlimited period. I shall not demand any fees (licences) for the use of the photographs." Name in block capitals: Date / signature: Practice name

STEPPS™ Photography– Declaration of consent Practice · STEPPS™ Photography– Declaration of consent Practice Declaration of consent Please have all persons photographed sign

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Page 1: STEPPS™ Photography– Declaration of consent Practice · STEPPS™ Photography– Declaration of consent Practice Declaration of consent Please have all persons photographed sign

www.dentsplysirona.com

STEPPS™ Photography – Declaration of consent Practice

Declaration of consent

Please have all persons photographed sign here:

"I give my consent that the photos on which I appear may be used for all communication activities of the practice above and for an unlimited period. I shall not demand any fees (licences) for the use of the photographs."

Name in block capitals: Date / signature:

Practice name