Consent Forms: Photos, Video, Audio & Testimonials

A media consent form is necessary to get explicit permission from any person who is not a student, faculty or staff member at Washington University whose name, likeness or words appears in your group’s communications, promotions or other media. For example, you must get their signed consent in order to use their name, likeness or words in photos, videos, audio recordings and testimonials.

Consent is not required for Washington University students, faculty and staff. As a courtesy, please advise these individuals of the purpose of the shoot or interview.

If you have any questions about the consent process, including acquiring the necessary permission for recording visiting speakers and lecturers, please contact us.

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Patients

Use the online HIPAA media release form.
Updated 3/1/23

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Non-patients (including models posing as patients and visiting speakers or lecturers)

If the communication is unrelated to clinical care, use this general media release form.

Media release form (pdf)
Updated 5/1/14

For minors/children: Media release form (pdf)
Updated 1/20/16