Consent form for Photography and Videos

This form is to confirm that I,

have agreed with Linia Medical Group that I am happy to take part in publicity for social media/marketing to help promote the company following the professional care and service I have received from them to date and in the future.

Purpose of Use:Educational content (e.g., before/after comparisons), Social media posts (Instagram, Facebook, TikTok, etc.), Website and promotional materials , Advertisements and marketing campaigns

I am aware that publicity could include the following:

1. Pictures of you before and after your treatment (non surgical) or (surgical) YesNo

2. Marketing material such as brochures/leaflets/ information booklets YesNo

3. Linia Website pictures YesNo

4. Patient information case studiesYesNo

5. Instagram, Facebook and TikTok YesNo

6. Local/national newspaper adverts/articlesYesNo

7. I can confirm these images/videos can show identifiable facial featuresYesNo

If you do not wish for a certain part of the photo to be shown, for example the eyes we can edit the photos or crop them so they will not be displayed. Photos used online will be adjusted so you do not see the full photo, as an example, for breast augmentation the nipple area will not be shown.
Please add a comment:

Right to Withdraw:I understand that I may revoke this consent at any time by providing written notice to Linia. However, I acknowledge that any previously published content cannot be retracted once posted or printed.

Legal Release:I release Linia Medical Group, its employees, and any third parties from any claims, demands, or liabilities related to the use of my images and recordings.

Signature

Name

Instagram handle:

Confirmed by (on behalf of Linia)

Date