Get Marketing Release Form

Filling out the Marketing Release Form online is essential for ensuring that you receive important communications regarding your health and treatment. This guide provides a comprehensive overview of the form's sections and offers step-by-step instructions to assist you in completing it accurately.

Follow the steps to fill out the Marketing Release Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor. This will allow you to access the Marketing Release Form in a user-friendly format.
2. Begin by entering the date at the top of the form. This is important for record-keeping and ensures that your consent is up to date.
3. In the designated field, insert your name or the name of your representative. This clearly identifies the individual granting consent.
4. Read through the consent section carefully. Ensure you understand that you are agreeing to receive communications about your health and treatment from Nexus Dental Alliance.
5. Review your contact information, as it is your responsibility to keep it current. Make sure to provide accurate details for receiving notifications.
6. After reviewing, sign the form in the appropriate space to validate your consent. If you are completing this form on behalf of another person, ensure you are legally authorized to do so.
7. Print the name of the witness in the specified field. This ensures an additional layer of validation for the consent provided.
8. The witness must also provide their signature. This step formalizes the acknowledgment of the consent process.
9. Move to the 'Acknowledgment of Receipt' section. Here, you should print your name, sign the form, and date it to confirm that you have received the Notice of Privacy Practices.
10. Finally, review all sections to confirm accuracy. Once you have completed the form, you can save your changes, download, print, or share it as needed.

Complete your Marketing Release Form online today to ensure you receive important updates regarding your health.