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Information About How To Submit Your Picture For Posting On The Orthodontic Information Page Copyright © 1996 Rich Masel

Steps To Submit Your Picture For Posting On The Orthodontic Information Page

  1. Take a picture of yourself with braces. Make sure that the braces show and that you are smiling.
  2. Print out a copy of this page, and fill out the form below
  3. Be sure to sign and date the form.
  4. If you are under 21 your parents will also have to sign the form.
  5. Email the form and the picture of you in braces to:

We will display the first 9 pictures we receive each month



Our lawyer tells us that we need to get your written permission before we post your picture. Your parent's signature is also required if you are under 21. Therefore, we will only accept forms submitted by snail mail. No email submissions will be considered


Please enter your name
Please enter your
street address

Please enter your city, state
Country postal code or zipcode
Phone number for questions
Email for questions

Please enter your orthodontist's name
Please enter your
orthodontist's
street address
Please enter his city, state
postal code or zipcode



I give permission to Richard Masel, and the Orthodontic Information Page to post the enclosed picture on the internet


Please sign here If you are under 21 ask your
parents to sign here		Date


Copyright © 1996, 1997, 1998, 1999, 2000, 2002 Masel books. All copying of the site is strictly forbidden.

Disclaimer: These FAQs are meant to provide general information about orthodontic treatment. The FAQ does not provide medical advice, and should not be used as a substitute for medical advice. Rich Masel and Masel Industries, Inc provide no warranty and accept no liability for the information disclosed here. FOR MEDICAL ADVICE SEE YOUR ORTHODONTIST.

This site is not connected to lesaM, the operating company for Masel orthodontics Legal and Privacy Information

 

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