As an employee, contractor and/or medical staff member of Optim Health System (“OHS Company”) and Surgery Partners (“Company”), I hereby give to OHS Company and Company, its legal representatives and assigns, affiliates, those for which OHS Company and Company is acting, and those acting with OHS Company and Company’s permission, my permission to take and utilize (i.e. publish, post, reproduce, distribute) photographs of me and use them for any legal purpose including but not limited to the OHS Company and Company’s social media accounts. I understand that I will not be paid for providing these photographs and I hereby waive any right to inspect or approve the finished photograph or advertising copy that may be used in conjunction therewith or to the eventual use that it might be applied. I release OHS Company and Company its officers, employees, and agents, from any and all claims of harm and liability as a result of any distortion, blurring, or alteration, optical illusion, or use in composite form, either intentionally or otherwise which may occur from making, showing, using or distributing these photographs/video. I HAVE READ THIS RELEASE AND CONSENT FORM BEFORE SUBMITTING THIS INFORMATION, AND I UNDERSTAND AND AGREE TO ITS TERMS. I HAVE READ AND AGREE TO PHOTO RELEASE (REQUIRED)