XCEL Orthopedics, Rochelle Community Hospital, Gadini O. Delisca, M.D, Rochelle, Sycamore, IL
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Testimonial Release Consent
You hereby irrevocably authorize XCEL Orthopedics, Rochelle Community Hospital, Gadini O. Delisca, M.D, Rochelle, Sycamore, IL to copy, exhibit, publish, or distribute your testimonial for the purpose of publicizing XCEL Orthopedics, Rochelle Community Hospital, Gadini O. Delisca, M.D, Rochelle, Sycamore, IL services or for any other lawful purpose.
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You also authorize XCEL Orthopedics, Rochelle Community Hospital, Gadini O. Delisca, M.D, Rochelle, Sycamore, IL to use your name and/or biographical information along with your testimonial and waive any right to inspect or approve the finished product, including any text or video wherein your testimonial appears.
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