Photo Release Form

Photo Release Form

"*" indicates required fields

At Chatterbox Pediatric Therapy, we love to celebrate the milestones reached by the children we treat as well as all the fun we have at work! Please note that we will not post any photos or videos of your child unless written permission is given by signing the form below.
ACKNOWLEDGEMENT*
Reset signature Signature locked. Reset to sign again
Date*

Scroll Back to Top