Orthodontic Smile Transformation Media Release Form

Transform Patient Success Stories into Powerful Marketing with Our Orthodontic Media Release Form

For orthodontic practices, patient smile transformations are your most compelling marketing asset. Before-and-after photos, video testimonials, and treatment journey content drive referrals, build trust, and showcase the life-changing results you deliver every day. But capturing and using this content requires proper consent—especially when working with teen patients and their families.

Our Orthodontic Smile Transformation Media Release Form is specifically designed for orthodontists, dental practices, and aligner providers who want to showcase patient results professionally and compliantly. Whether you're running Instagram campaigns, creating website testimonials, or producing TikTok content featuring your amazing transformations, this template ensures you have the proper authorization from patients and their legal guardians.

Why Orthodontic Practices Choose This Template

Purpose-built for orthodontic marketing needs: This isn't a generic photo release form. It's tailored specifically for orthodontic practices that want to feature braces transformations, aligner journeys, retention success stories, and teen testimonials across multiple marketing channels. The form addresses the unique considerations of orthodontic content, including treatment duration, before-and-after comparisons, and the specific platforms where this content performs best.

Parent and guardian consent made simple: Since many orthodontic patients are minors, this template includes proper fields for parental consent, relationship verification, and legal guardian authorization. You'll capture everything needed to confidently feature teen transformations in your marketing while respecting family privacy preferences.

Multi-channel usage rights: Modern orthodontic marketing happens everywhere—Instagram Reels, TikTok, Facebook, YouTube, your website, printed brochures, in-office displays, and even local news features. This form covers all these bases with clear, comprehensive media usage rights that protect your practice while giving patients control over how their images are used.

HIPAA-conscious design: While Paperform itself is not HIPAA compliant, this template is designed with healthcare privacy principles in mind. It separates consent for treatment from consent for marketing, clearly outlines what patient information will be used, and gives patients granular control over their participation—important considerations for any healthcare practice.

Perfect For These Healthcare Professionals

• Orthodontists creating smile transformation content for social media and website galleries
• Clear aligner providers (Invisalign, Byte, CandidPro) showcasing treatment results
• Pediatric dental practices with orthodontic services featuring teen patient journeys
• Dental marketing coordinators managing patient photography and testimonial campaigns
• Orthodontic group practices standardizing consent across multiple locations
• Dental social media managers sourcing authentic patient content for campaigns

What Makes This Template Work

Comprehensive consent coverage: Capture permission for photos, videos, written testimonials, social media tags, and even participation in case study content. Patients can choose exactly what they're comfortable with, giving you clear boundaries for content creation.

Before-and-after specific fields: Orthodontic marketing is all about the transformation. This form includes specific language about treatment progress photos, comparison images, and documenting the journey from start to retention—exactly what drives engagement and conversions.

Teen-friendly and parent-accessible: The form uses clear, approachable language that teens can understand while providing all the legal protections parents need. It strikes the right balance between professional healthcare documentation and family-friendly communication.

Flexible revocation options: Patients and parents can indicate if they want the ability to withdraw consent in the future, building trust and showing respect for evolving privacy preferences—especially important for teens who may have different feelings about social media presence as they mature.

Practice information and contact details: Collect essential information about the patient's treatment type (braces, aligners, retainers) and preferred contact methods, making it easy to follow up when you're ready to feature their transformation.

Streamline Your Marketing Workflow with Automation

Once you've collected media release consent, Paperform's native integrations and Stepper workflows can automate what happens next:

• Organize by consent type: Automatically send submissions to different Google Sheets tabs or Airtable bases depending on what media types patients approved
• Tag in your CRM: Update patient records in your practice management software or HubSpot with media release status
• Notify your marketing team: Send Slack or email alerts when a great transformation candidate gives full consent
• Schedule follow-ups: Trigger reminders to reach out to patients at the end of treatment when their results are showcase-ready
• Create content calendars: Feed approved patients into your social media planning tools automatically

With Stepper, you can build multi-step workflows that route consents through your marketing approval process, update multiple systems simultaneously, and keep your team coordinated—all without writing a single line of code.

Customize for Your Practice's Brand

While this template is ready to use immediately, Paperform's doc-style editor makes it simple to customize every detail:

• Add your practice logo, team photos, and office imagery to reinforce your brand
• Adjust the language to match your practice's voice—whether that's clinical and professional or warm and family-focused
• Include examples of the types of content you create (link to Instagram, show sample before-and-afters)
• Add fields for specific campaigns or seasonal promotions you're running
• Embed the form directly on your practice website for seamless patient experience

Build Trust and Grow Your Practice

Patient testimonials and transformation photos are proven to be the most effective marketing for orthodontic practices. This template helps you collect this valuable content ethically, professionally, and efficiently—turning your happiest patients into your best ambassadors.

Trusted by healthcare practices nationwide, SOC 2 Type II certified, and featuring beautiful, conversion-optimized design, Paperform gives you the tools to grow your orthodontic practice through authentic patient stories—all while respecting privacy and building lasting trust with families.

Start collecting smile transformation consent today and turn your clinical excellence into marketing gold.