Share Your Story

I hereby grant to Neuliven Health the right and permission to reproduce, publish, distribute and use my name, likeness, biographical information, personal testimonials, and any photographic images of me provided by me to Neuliven Health “Share Your Story” (the "Testimonial") in connection with the advertising and marketing of Neuliven Health, in such manner, for such purposes, and with such frequency as Neuliven Health shall determine in its sole discretion without compensation or consideration to me and without further authorization from me. I understand the Testimonial may be used in any form of media, including Internet or print. The Testimonial shall be the sole property of Neuliven Health. I waive rights of inspection or approval with regard to use of the Testimonial. I also release, discharge and agree to hold harmless Neuliven Health, its shareholders, officers, directors, employees, agents, affiliates and assigns from and against any and all liability resulting from use of the Testimonial.

I hereby represent and warrant that (1) the Testimonial shall be an honest and truthful description of my personal use of Glucocil; (2) I am at least eighteen years of age and competent to contract in my own name; and (3) I have read this release, and I fully understand the contents thereof.