FISHER HOUSE GUESTS
HELP US HELP YOU, PLEASE FILL OUT THE FOUR FORMS BELOW.
THANK YOU FOR YOUR SUPPORT!
1) GUEST INFORMATION
This information will be used for grant and funding purposes.
2) GUEST SURVEY
HOW WAS YOUR STAY?
We are here for you!
Thank you for your feedback!
West Palm Beach VA Healthcare System
7305 N. Military
Trail
West Palm Beach, Florida 33410-6400
https://www.va.gov/west-palm-beach-health-care/
Local VA Connect: 1-561-422-6838
Toll Free VA Connect: 1-866-383-9036
VA Tel-Care Nurse (After 4:00 P.M.): 1-877-741-3400
3+4) PHOTO RELEASE FORMS
To be eligible for the Patriot magazine we must have your consent.
3) FRIENDS OF FISHER HOUSE PHOTO RELEASE
Friends of Fisher House, Inc., West Palm Beach. Consent for use of Photography, Picture, Video, Quotes and/or Voice.
4) FISHER HOUSE FOUNDATION
CONSENT FOR USE OF PHOTOGRAPHY, PICTURE, VIDEO, QUOTES AND/OR VOICE
I hereby voluntarily and without compensation grant to Fisher House Foundation the irrevocable and unrestricted right to use and publish my name, photography, photographs, indirect and direct quotations, video footage and/or voice recordings of me, or in which I may be included, for print publications, electronic reproductions, social media and/or promotional materials – or any other purpose and in any manner or medium relating to the promotion of Fisher House. In addition, I grant my permission to alter the same without restriction; and to copyright the same if required. I hereby release Fisher House, the photographer, the videographer, and the advertising agency from all claims and liability relating to said materials. I understand that my consent or refusal to consent to this agreement will have no effect on my eligibility for Fisher House programs now or in the future.