Consent to Digital Dental Photography Consent to Digital Dental Photography This is to authorise Dr. Sheraz Burki to take digital photographs/videos of my face, jaws and teeth, before, during and after treatment. I hereby consent to the use of said photographs/videos for the following purposes: • Dental records • Dental education including lectures, seminars and demonstrations • Professional or Marketing publications such as journals or books • Marketing material both digital (e.g. website) and printed • Patient education I understand that if said photographs/videos are used, my name and any other identifying information will be kept confidential. I do not expect any type of compensation, monetary or other, for the use of said photographs/videos. Patient Name (required) Book your appointment now!