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How to use or fill out INFORMED CONSENT FOR IMAGE TREATMENTS
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the practice name at the top of the form. This identifies where your consent is being given.
- In the AUTHORIZATION section, provide your name and check the box to authorize the use of your photographic/video images for marketing purposes.
- Review the PURPOSE section to understand how your images will be used, such as for social media or advertising.
- Fill in the DATE field and sign where indicated. If you are a personal representative, include your name and relationship to the patient.
- If applicable, complete the section for minors by providing parent or legal guardian details and signature.
- Finally, indicate if you would like a copy of this form by checking 'Yes' and initialing as required.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2017 | 4.4 Satisfied (58 Votes) |
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