Testimonials consent

Testimonial Release and Data Protection Agreement

Therapist: Nathalie Crittenden-Lopis
Practice: Your Therapy and Wellbeing (yourtherapyandwellbeing.com)

In compliance with GDPR, please complete this form only after payment of your deposit/session to avoid unnecessary data collection.

This agreement relates to any testimonial(s) provided by the Client to Nathalie Crittenden-Lopis, Your Therapy and Wellbeing (yourtherapyandwellbeing.com). By signing below, the Client acknowledges and consents to the following terms:

1. Consent to Use of Testimonial

  • The Client grants permission for Nathalie Crittenden-Lopis to use, reproduce, distribute, and disclose the content of their testimonial, including any photographic or videographic likeness.

  • The testimonial may be distributed publicly for purposes such as advertising, promotion, marketing, and press coverage.

2. Compensation and Waiver of Rights

  • The Client acknowledges that no compensation will be provided for the use of the testimonial (including photographic/videographic likeness).

  • The Client waives any right to payment or input concerning the testimonial’s use, except where use extends beyond the purposes outlined in Clause 1.

3. Right of Revocation

  • The Client retains the right to revoke this release at any time by providing written notice to Nathalie Crittenden-Lopis.

4. Approval and Release of Liability

  • The Client understands and approves the disclosure of their testimonial and related likeness in public relations or marketing efforts.

  • The Client waives any right to prior approval of how the testimonial is used.

  • The Client releases Nathalie Crittenden-Lopis, Your Therapy and Wellbeing (yourtherapyandwellbeing.com), from any claims or damages resulting from use of the testimonial, likeness, or related information.

5. Data Protection and GDPR Compliance

In line with GDPR and applicable Data Protection Regulations:

  • The Client acknowledges that their testimonial may include personal data, which will be shared publicly and used for the purposes described in Clause 1.

  • The Client has the right to access their personal data held by Nathalie Crittenden-Lopis, and may request corrections or deletion where appropriate.

  • By signing this form, the Client consents to their personal data being stored and processed in accordance with GDPR, and shared publicly for the purposes set out above.

6. Governing Law

This agreement is governed by the laws of England and Wales. The Client consents to the exclusive jurisdiction of the English courts in relation to any matters arising from this agreement.

7. Statement of Consent

By signing this agreement, the Client confirms that they:

  • Have read and understood the terms of this release.

  • Consent to the use of their testimonial (and/or photographic/videographic likeness).

  • Consent to the processing and public sharing of their personal data as outlined.

Signatures

Therapist:
Signed: ______________________ Nathalie Crittenden-Lopis, Your Therapy and Wellbeing (yourtherapyandwellbeing.com)
Date: ______________________

Client:
Signed: ______________________

Name: ____________________________________
Date: ______________________

Initials (for consent to all terms): _________

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