I hereby authorize Kandu Health, Inc. (“Kandu”) and those acting pursuant to its authority to reproduce, edit, broadcast, display, or publish, in whole or in part, written, audio, graphics or photographs related to me, prepared by me or with my authorization and approval.

Identifying Information: I grant Kandu the right to use my name, biographical information (including my medical diagnosis and age), likeness, image, and other words or graphic images that distinctly identify me for the purposes of duplicating, distributing, and promoting Kandu’s services in any media, including in connection with the promotion of Kandu’s mobile application and navigator services.

If you do not give Kandu full permission to use your name, image or other identifying information please check one of the boxes below:

Do not use my name, likeness, image, or other words or graphic images that distinctly identify me.Do not use my name, but Kandu may use my image in connection with the written statement, video or photographs as described above.Do not use my image, but Kandu may use my name in connection with the written statement, video or photographs as described above.

Release and Rights

I understand that Kandu may use, edit, exhibit, or distribute my audio, graphic or video statements, or photographs, together with such identifying information as I authorize to be used, without restriction or limitation, for any purpose which Kandu deems appropriate.

I hereby consent to the release of said audio, graphic or video statements, or photographs for use in printed materials, electronic materials, video, audio, film, photograph, or any other media for any purposes and in accordance with the terms stated above, on any platform, including websites, social media, electronic mail, applications, print, television, or radio. I understand that my consent is limited to written statements, audio, graphic, video and photographs related to the story/stories described above, and my consent cannot later be revoked.

I hereby assign and transfer all my rights in and to the audio, graphic, video or photography related to the story/stories described above to Kandu, and I understand that Kandu may copyright the same in its name or any other name it may choose.

I release Kandu, and each of its officers, agents, and employees, from any and all liability connected with the use or disclosure of the written statements, audio, graphic, video or photographs described above. In return, Kandu also releases me from any and all liability connected with use or disclosure of the same.

I waive all rights, interest, or claim for payment in connection with any exhibition, use or disclosure of these audio, graphic, video or photographs described above.

By checking this box, I agree to the photo release terms and conditions as they are listed above.