I hereby grant permission to Alchemy Aesthetics Co. and its representatives to take and use clinical photographs and/or video recordings of me taken before, during, and after my treatment or procedure for the purposes of education, marketing, and documentation.

I grant permission for Alchemy Aesthetics Co. to use photographs, video, and related content of me for:

• Digital and print marketing

• Social media

• Email campaigns

• Educational materials

• Website content

• Presentations

• Other promotional outlets

I acknowledge and agree that:

• These materials may display my likeness and may be viewed by the public.

• I waive the right to inspect or approve the final product, including written or electronic copy, wherein my likeness appears.

• I waive all rights to compensation or ownership for the use of any such images or videos.

• This release is irrevocable and may not be withdrawn once content is published or distributed.

• I release and hold harmless Alchemy Aesthetics Co., its staff, representatives, and affiliates from any and all liability in connection with the use of such materials.

By signing below, I confirm that I am at least 18 years of age and have read, fully understand, and voluntarily accept the terms outlined in this Photo & Video Release.

By submitting this form electronically, I acknowledge that this digital signature has the same legal effect as a handwritten signature. I confirm that I am the individual named above and have the legal authority to provide this consent. I understand that this form and my digital signature may be retained by Alchemy Aesthetics Co. as part of my treatment record.

By submitting this form I agree to receive marketing email and text messages from Alchemy Aesthetics Co.