Harmony - Testimonial

Please be aware that there is no requirement to share your testimonial, deciding not to share your testimonial will not impact your treatment in any way.

Please type your name in the box below how you would like it to appear in marketing materials. If you would like to remain anonymous you may leave this field blank. Ex. Dr. John E. Smith PhD.

Check this box if you would like to remain anonymous.

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I would like to be contacted by:

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I acknowledge that my testimonial is voluntary and that participation, or lack thereof, will not impact the quality of care I receive from Harmony.*

I agree

I give Harmony the rights to reproduce my written in print, video, and audio marketing materials.*

I agree

I would like the marketing team to reach out to me about recording a voiceover for use in marketing purposes.*

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I would like the marketing team to reach out to me about recording a video for use in marketing purposes.*

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I would like to share my written testimonial below.*

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In the field below you may type your testimonial.

By signing below, I am acknowledging that I give permission for the use of the testimonial I have provided in marketing and promotional materials. I authorize Harmony and it's employees, contractors, partners, and other representatives to use my testimonial in marketing and promotional efforts, including, but not limited to, advertisements, webpages, social media posts, brochures, videos, and more. I waive any claim to inspect, edit, or approve of any materials where my testimonial is used. I also waive any claim to copywrite my testimonial or material where my testimonial appears and waive any claims to financial compensation or gain from using my testimonial.

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