Patient Consent for Photographs and Measurements
I, [Patient's Full Name], hereby consent to the taking of photographs and measurements of my body for the purpose of documenting and assessing the results of the medical or aesthetic procedure(s) I am undergoing. I understand that these photographs and measurements will be used to evaluate my progress, document changes, and potentially for educational or promotional purposes.
I understand and agree that:
Photographs and Measurements: Photographs and measurements will be taken before the procedure and at specified intervals afterward to track and evaluate the results. Use of Images and
Measurements: The photographs and measurements may be used for purposes including, but not limited to, medical documentation, patient progress evaluation, and educational or promotional activities related to the procedure. This may include use in presentations, marketing materials, or publications.
Confidentiality and Privacy: My identity will be protected, and the images and measurements will be used in a manner that respects my privacy and complies with applicable laws and regulations.
Voluntary Participation: My consent to the use of these photographs and measurements is voluntary and I understand that I may withdraw my consent at any time by notifying the healthcare provider in writing. I also acknowledge that withdrawing my consent may affect the continuity of my care and evaluation of results.
Questions and Understanding: I have had the opportunity to ask questions about this consent, and all my questions have been answered to my satisfaction. I understand the content of this consent form and agree to the use of my photographs and measurements as outlined.
I have had the opportunity to ask questions about this consent and all my questions have been answered to my satisfaction. By signing below, I consent to the use of photographs andmeasurements as described above.