Patient Story Consent Form

Patient Story Consent Form
Your details
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
I'm a parent or guardian of someone under 16, and giving consent on their behalf
Your age (If you're under 16, you'll need a parent or guardian to fill out this form on your behalf)
We will only contact you in relation to our use of the content you have provided. Unless you have opted in to receive communications from Scotland's Charity Air Ambulance elsewhere.

Withdrawing or changing consent
You can withdraw or change your preference for the use of your content at any time. If you no longer wish to share your story or want to change how it is used, contact us at communications@scaa.org.uk and we will act on your decision within 7 days. It may not always be possible to withdraw materials already published or issued before you withdrew consent.
I hereby give my informed consent to share my story with Scotland's Charity Air Ambulance.

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Your details