This Client Photo & Media Release Form is designed for practices that need documented permission before using client photos, videos, testimonials, or session-related media. It covers the essentials: legal name, contact details, session date, the types of media approved, where that media may appear, and how the client prefers to be identified.
The template is especially useful for wellness, coaching, therapy, and healthcare-adjacent businesses that want a professional consent form online without leaving important details open to interpretation. Clients can choose whether their media may be used on a website, social media, email campaigns, printed materials, or presentations, and they can set privacy preferences such as full name, first name only, initials, or anonymity.
It also includes practical safeguards that make review easier for your team, such as space for special restrictions, optional testimonial text, and a defined consent period. For teams comparing options in a form builder for small business, this template offers a strong starting point for collecting informed permission in a way that is organized, specific, and easy to adapt.
