Out of the Darkness
and into the Light
Call Today (310) 519-8723
After Business Hours (310) 833-7400
Photo & Video Release Form
Please fill out the photo release form if you are appearing on camera for any activities at Fred Brown Recovery Services, and you agree to allow the use of your photo and / or video and / or audio.
PHOTO RELEASEPermission to Use Photograph, Video and Audio
I understand that confidentiality is protected under federal regulations which govern and protect the confidentiality of substance abuse disorder clients.
Whether or not I am a client or family member and notwithstanding my rights under the law:
I have read, understand and agree to the above:
Type your full name below to serve as your signature agreeing to this form. A copy of this will be emailed to the email address you provide above.