Share your story

What can you do today because of your orthopaedic care? We'd love to hear your success story!

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    Marketing Consent

    I hereby authorize Knoxville Orthopaedic Clinic (KOC) to publish the personal health information/story I provided to be used in print media, on the radio, TV, the KOC website, blog and on the following social media platforms: Facebook, Twitter, Pinterest and YouTube.

    1. Revocation: I understand that I may revoke this authorization at any time by sending a written notice to KOC. However, the revocation will not have any effect on any uses or disclosures KOC may have made before the revocation was received.

    2. Expiration: I understand success stories posted by KOC may stay on its website and social media for an indefinite period of time.

    3. Redisclosure: I understand that once my protected health information is used and/or disclosed pursuant to this authorization, it may be subject to redisclosure by the recipient(s).

    4. Refusal to Sign: I understand that I may refuse to sign this authorization and that KOC will not condition treatment on whether I sign this authorization.

    5. Compensation: I understand that I will receive no financial compensation for the use of my image or protected health information as described herein.

    6. Copy: I understand I have a right to request a copy of this authorization.

    7. Certification: I certify that I am the patient or the patient’s authorized representative.