Client Testimonials Share Your Thoughts Practice Type Select One Private Practice (1 to 2 locations) Clinical (Gov’t funded/subsidized practice) Small Group (3 to 29 locations) Large Group (30+ locations) Dental Management Company Other Other Practice Type Practice City State Select One Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Share Your Thoughts Confirm × Terms & Conditions I give my permission to Henry Schein Nationwide Dental Opportunities, its subsidiaries and affiliates and/or any successor and/or assignee (“Henry Schein NDO”) to use, display, digitize, reproduce, and distribute (collectively, “Use”) my testimonial, letter of recommendation or other feedback (whether written, oral, recorded or otherwise) in its marketing materials, in any media, and on its website, or the mobile version thereof. Henry Schein NDO may also include my full name or initials, title, and city, state. This identification information along with my testimonial, letter of recommendation or other feedback shall be referred to together as a “Testimonial”. I agree that Henry Schein NDO may, in its discretion, use the Testimonial, use excerpts therefrom, or edit my Testimonial, so long as it such editing does not create a misleading impression of my views, and may use the original or edited Testimonial or excerpts therefrom. I hereby transfer and assign all right, title, and interest in and to the Testimonial, including but not limited to perpetual worldwide copyright rights thereto, to Henry Schein NDO. I hereby waive all rights under privacy, publicity, defamation, and proprietary rights relating to the Testimonial. I represent that my Testimonial is a true and accurate depiction of my experience and that I have not been compensated by Henry Schein NDO for such Testimonial. I represent that I have the right to enter into this Release Agreement. I release, indemnify, and hold Henry Schein NDO, its licensees, successors, and assignees harmless against all claims, liabilities, and expenses arising out of the breach of any of my representations or promises. I have read and understand the terms and conditions of this Release Agreement and acknowledge that I am providing my electronic signature for the release of my testimonial. Download the terms and conditions as a PDF By checking this box you indicate that you have read and understand the Terms and Conditions of this Release Agreement. Please provide your electronic signature below to indicate that you have read and understand the Terms and Conditions. Submit