The document contains a repeated form granting Newvision Dental Laboratory permission to upload photos to their Facebook page and website, add photos to their newsletter for dentists, publish any comments, and add the form page to their work profile file. The form includes a notes section for additional information.

1. Implant and Post
Supported
Crown & bridge
work

2. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.

5. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

6. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.

8. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

10. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

11. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

12. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

13. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

14. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

15. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.

16. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.

17. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

18. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.

22. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

24. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

25. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

26. I hereby give Newvision Dental Laboratory permission to:
 Upload my photo’s to their facebook page & website.
 Add my photo’s to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

27. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

28. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

29. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

30. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

31. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

32. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________

33. I hereby give Newvision Dental Laboratory permission to:
 Upload my photos to their facebook page & website.
 Add my photos to their news letter to the dentists.
 Publish any comments made by me.
 Add this page to their work profile file.
 Notes:______________________________________________