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Sample Consent for Clinical Photography, Videotaping

    https://library.ahima.org/doc?oid=99416
    Sample Consent for Clinical Photography, Videotaping, Audiotaping, and Other Multimedia Imaging of Patients. This sample policy and procedure is not intended for adoption as a substitute for a customized internal organizational specific policy and …

CONSENT TO PHOTOGRAPHY - hartfordhospital.org

    https://hartfordhospital.org/File%20Library/Hartford%20Hospital%20Forms/Consent%20Forms/Photography%20Media/571940.pdf
    hereby waive all rights and release Hartford Hospital from any claim or cause of action, whether now known or unknown, for defamation, invasion of right to privacy, publicity or …

Patient Consent for Medical Photography (1) - Vincent C.

    https://www.drhungmd.com/wp-content/uploads/2014/01/Patient-Consent-for-Medical-Photography.pdf
    consent for medical photographs to be made of me or my child (or person for whom I am legal guardian). I understand that the information may be used in my medical records, for …

Patient Photo Release Form Template | Jotform

    https://www.jotform.com/form-templates/patient-photo-release-form
    A Patient Photo Release Form is a waiver exercised the patient in allowing the use of photographs which the patient is the subject, and to the benefit of the medical service provider or institution. This patient releasing the …

Consent to Photograph and Authorization for Use or …

    https://calhospital.org/wp-content/uploads/2021/04/Form_24-4.pdf
    Consent to Photograph and Authorization for Use or Disclosure Patient Name: Consent to Photograph hereby consent to be photographed while receiving treatment at the …

Medical Photography Consent Form - Cockerham, MD

    https://www.cockerhammd.com/webdocuments/Photo-consent.pdf
    further acknowledge that there were no promises of compensation for such use of medical photo(s) and or video taken by Zeiter Eye Medical Group, Inc. as consented above. This …

Consent to Photograph, Video, or Audio Record

    https://www.uab.edu/toolkit/images/photo-video/health-care-media-release.pdf
    I, the undersigned, agree and authorize UAB Health System Operating Entities including UAB Hospital, University of Alabama Health Services Foundation (HSF), The Kirklin …

Free Photo Consent Form - PDF | Word – eForms

    https://eforms.com/consent/photo/
    The form, aside from granting permission to the requesting party, will include a description of the photo (s) being requested. A revocation clause is included to allow the individual providing consent to …

Free Photo Consent Forms (Minor & Adult) Word | PDF

    https://www.wordtemplatesonline.net/photo-consent-forms/
    Photo consent forms are relatively straightforward. It should have the full name and address of the “releasor” as well as the “releasee.” It should then have a description of the photo you are asking to have consent for. …

FREE Photo Consent Form [PDF, WORD] - sampleforms

    https://www.sampleforms.com/editor/sf/consent-form/photo-consent-form/
    What Is a Photo Consent Form? A photography or photo consent form is a form filled out by the releasor (owner of the images or photographs) to permit the releasee (person …



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