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I hereby authorize my testimonial to be used for testimonial advertisement in Dr. Kevin B. Riche’s promotional material, including Dr. Kevin B. Riche’s website, brochures, and advertisements. I waive the right of prior approval and hereby release and discharge Dr. Kevin B. Riche and all persons acting under the permission and authority of Dr. Kevin B. Riche from liability, damages, compensation or actions of any kind based on the use of my testimonial or information in the testimonial.

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8080 Bluebonnet Blvd, Suite 1000, Baton Rouge, LA 70808