№ lp_2_3_18447
Administrative consent form authorising the use of an individual’s image, interview or personal details by a healthcare partnership for publication and media purposes under specified conditions.
Organisation: Humber, Coast and Vale Health and Care Partnership
Type of document: Consent form
Subject: Consent to use image, audio, filmed interview or written piece
Age requirement: 16 years old or over
Purpose: Representation, promotion and feedback regarding healthcare services
Media formats: Printed publications, displays, exhibitions, websites, social media, local and national media
Period of use: Up to five years
Copyright holder: Humber, Coast and Vale Health and Care Partnership
Withdrawal of consent: By phone (01482 344 700) or email ([email protected]
Note: )
Address: 2nd Floor, Wilberforce Court, Alfred Gelder Street, Hull, HU1 1UY
Telephone: 01482 344 700
Required information: Signature, printed name, telephone number, mobile number, address, date
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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