A. Liability

I hereby give to Medicaid Planning Services the absolute and irrevocable right and permission with respect to the review that they have taken of myself:

To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other reviews, in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and;

I hereby release and discharge Medicaid Planning Services from any and all claims and demands ensuing from or in connection with the use of the review, including any and all claims for libel and invasion of privacy.

B. Release

By signing this release form I hereby allow Medicaid Planning Services to post my review as a Medicaid Planning Services Google Review. I also state I have read and agreed to all of the above in cooperation with Medicaid Planning Services in the free use of my Google review.

Print Your Full Name and Sign Below

Thank you for working with Medicaid Planning Services!

Print Name