By submitting your testimonial, you are authorizing and releasing your testimonial information to Dr. Michael P. Girskis DDS, MS & Associates. You understand your testimonial made may be used in connection with publicizing and promoting Dr. Michael P. Girskis & Associates practice. You authorize The Practice of Dr. Michael P. Girskis to use your name, brief biographical information, and the testimonial as defined on this form. You hereby irrevocably authorize Dr. Michael P. Girskis practice to copy, exhibit, publish or distribute the testimonial for purposes of publicizing The Practice’s services or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media.
Please contact our office if you have any questions or concerns about the submission of your testimonial.