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Consent Agreement

This consent is valid for 3 years. You can change or end your agreement at any time prior to the end of the 3-year period from the date signed below. You will need to send a written letter to: On Lok Compliance Officer, 1333 Bush Street, San Francisco, CA 94109. When you send in your written letter, we will stop any new use of your testimonial by On Lok although we cannot remove your testimonial from printed publications or videos already created. However, sometimes the photos or information may have already been given to the media or someone outside of On Lok. In that case, we won’t be able to discontinue this use.

I give consent for my testimonial to be used by On Lok Lifeways.

I am providing this testimonial and understand it may be used in On Lok Lifeways materials, which may include publicity, newsletters, community education, advertising, fundraising, news-gatherings, special events, or media events. I am aware that when others read or hear the testimonial, people may know that I am affiliated with On Lok Lifeways and learn information about me.