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By checking this box, I consent to Newton Healthcare Corporation and all partnering agencies to use my video, story, likeness and voice as they see fit. I understand that I am relinquishing my right to inspect final usage of all items submitted. I further agree that I will not receive any financial remuneration for the use of my submission. Upon submission, this content is no longer considered protected health information (PHI), and may be used for marketing and educational purposes.

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