Case Study Release Form

Please complete this form to obtain consent for using an individual’s information, feedback, or experience in a case study.

Participant Information

Project/Case Study Details

Consent Authorization

I give permission to [Organization's Name]to use my information, feedback, and/or experience for the purposes of this case study. I understand that this may include, but is not limited to, publication in reports, articles, and other materials.

Participant Signature

Name:

Date:

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