Thank you for taking the time to fill out this form. We, at Tennessee Overdose Prevention, are grateful that you are allowing us to use your loved one's photo as we can honor those we have lost. This form is only for those who were lost in Tennessee or who have family in Tennessee. Contact us if you live in another state and will send links where you can post nationally or in that state.
In this form, we are asking for your permission to use a loved one's likeness in a photograph for any events, memorials, and promotional materials as we remember those affected by addiction and educate, implement, and develop resources for Tennessee Citizens regarding Tennessee's Naloxone and Good Samaritan Laws.
In addition, we also ask in this form if you are comfortable with us as we share these resources with friends in the recovery community. We trust these partners (and believe they will respect your stories), but we also prioritize your privacy and peace of mind.
If you have multiple family members you would like to include, please submit one form for each person. If your loved one' photo is already on the carousel on our website's homepage (tnoverdoseprevention.org
), you do not need to submit this form.
You will know we have received your response when you see your loved one's photo in the "Remembering Carousel" on the homepage of our website, http://www.tnoverdoseprevention.org
. You have to send the head shot photo through an email before it will be added to the carousel.
You will only receive an email if there was a problem with your submission, like if we don't receive a head shot, or if your photo has more than one person in it. Please do not resubmit the form thinking that we did not receive the first form that you filled out.