Home
Forms Library
Benefits Summary - UNC Medical Center

Benefits Summary - UNC Medical Center 2026

Benefits Summary - UNC Medical Center Preview on Page 1

See details

4.7 out of 5

22 votes

The document is a Patient Photograph/Video & Information Release Authorization Form from the University of North Carolina Health Care System. It allows patients to authorize the use of their photographs and videos for various purposes, including public relations, medical education, and publications. The form outlines the patient's rights regarding consent, revocation of authorization, and potential privacy implications. It also includes sections for patient identification and signature.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Benefits Summary - UNC Medical Center with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Benefits Summary in the editor.
Begin by entering the patient’s name in the designated field for photography/videography release. Ensure accuracy as this will be used for identification purposes.
Check all applicable boxes under the Photography/Videography Release section to indicate how you authorize the use of images. This includes options for public relations, educational purposes, and more.
In the Information Release section, decide whether you consent to the use of your name. If you do not consent, check the appropriate box and understand that recognition may still occur.
Fill in any additional information about your medical condition or treatment if you authorize its use. Be specific to ensure clarity.
Sign and date the form at the bottom. If an authorized representative is signing, provide their details and authority explanation.
Finally, fax the completed form to Medical Information Management at (919) 966-0839 as instructed.

Start using our platform today for free to streamline your document editing and signing process!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much do UNC resident doctors make?

The average Resident Physician base salary at UNC Health is $70K per year.

What is the pay scale at UNC hospitals?

Hourly pay at UNC Hospitals ranges from an average of $15.93 to $43.56 an hour. UNC Hospitals employees with the job title Registered Nurse (RN) make the most with an average hourly rate of $34.89, while employees with the title Certified Nurse Assistant (CNA) make the least with an average hourly rate of $18.15.

Are UNC hospital employees state employees?

CHAPEL HILL, N.C. UNC Health has signed a new, long-term agreement with UnitedHealthcare. The multi-year deal will allow United members across North Carolina to continue receiving uninterrupted care from UNC Health providers, clinics and hospitals.

How much does a 2nd year resident doctor make?

$47,000 is the 25th percentile. Salaries below this are outliers. $66,500 is the 75th percentile.

How much do UNC hospital employees make?

UNC Health salaries can vary greatly by role, ranging from $41,860 per year (or $20 per hour) for Certified Nursing Assistant CNA to $134,475 per year (or $65 per hour) for Physician Assistant. This is based on 3347 salaries submitted on Glassdoor by UNC Health employees as of September 2025.