Authorization for Audio Visual Monitoring During Ashley Transportation

To ensure your safety, Ashley’s vehicles are equipped with audio and visual monitoring and records during any transportation in these vehicles while in treatment, including transport to and from the treatment facility.

I authorize Ashley, Inc., acting through its employees, to take video and audio recordings of me which may include my name, image, voice and actions during transport in an Ashley vehicle.

I understand these recordings are being done for my own protection, the protection of Ashley’s employees, as well as for Quality Improvement purposes and will be kept confidential.

I release Ashley, Inc. and its employees from any claim, damages or liability arising from or related to the recordings collected during transport.

I acknowledge that I have carefully read this Consent and Release form, that I fully understand its contents and agree to be bound by it. I certify that I am 18 years of age or older.

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