Retouching Request:

Medical Affiliates: This form is for UNAFFILIATED Medical and Family only. If you are a NILMDTS Medical Affiliate, please log in to submit a retouching session. We encourage any currently UNAFFILIATED medical providers to learn more about our Medical Affiliation Program to become affiliated as well as earn contact hours.
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To search a location, please type valid zip code.
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If you cannot find the hospital you are looking for, please input its name and address in the fields below.
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Invalid email! Please enter email in "example@example.com" format.
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Baby:

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Parents:

Mother

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Partner

Contact Info

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Invalid email! Please enter email in "example@example.com" format.
Invalid email! Please enter email in "example@example.com" format.

Consent Form & Images:

 * Parent consent forms are required for each session. Please download the Retouching Consent Form then scan or photograph the signed form and upload here.
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Images
Submit no more than 30 images for retouching. NILMDTS will not be able to complete requests with more than 30 images. All images MUST be submitted in a high-resolution form. Duplicate or extremely similar poses will be discarded and out of focus images will be retouched to the best they can however some may not be able to be retouched.

Retouching Request Submission Review


Please review this entire form before you submit. Make sure ALL fields with a star ( * ) are filled out and that contact numbers and email addresses do not contain errors. Upon receipt of this submission you will receive a confirmation email. If you do not receive submission confirmation, please check your spam or other filtered folders then contact us. It may take up to 6-12 weeks for retouching.
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Please consider making a donation to support this additional request.


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Note: Please click Save only once. If uploading large images, it may take up to 5 minutes. Please be patient.
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