By submitting my personal story or agreeing to be interviewed, I understand that Parryscope or Positive Steps Fertility may publish this information to other social media sites, to its website, and to any other company that promotes Parryscope or Positive Steps Fertility, including, without limitation, to any news media, all of whom may not be subject to the same federal health privacy laws.
I additionally understand that, once published or released, Parryscope or Positive Steps Fertility has no control over who views or uses the information. I further understand that Parryscope or Positive Steps Fertility cannot condition treatment or payment on whether I submit this information and that my healthcare or payment for healthcare will not be affected by my refusal. I also understand that submitting my story does not entitle me to any monetary or other compensation.
By submitting this entry, this authorization shall remain in effect until such time as I revoke the use of this information, which I can do at any time by submitting a written revocation to Parryscope or Positive Steps Fertility, and will be effective upon receipt by Parryscope or Positive Steps Fertility.