I hereby grant Trinh Health Services, McMaster University and their assigns, permission to interview me and/or to use my likeness in photograph(s)/video in any and all their publications, websites, and in any and all other media, whether now known or hereafter existing, controlled by Trinh Health Services, McMaster University and assigns, in perpetuity, and for other use by Trinh Health Services, McMaster University and their assigns. I will make no monetary or other claim against Trinh Health Services, McMaster University and their assigns for the use of the interview and/or the photograph(s)/video. [Please also download, complete, and mail in the form to our office, or fax to (905)648-4426.]