Healthcare Design Thinking Lab Filming Consent Form
Please complete this form to provide your consent for filming and use of footage during the Healthcare Design Thinking Lab.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Your Role or Affiliation (e.g., participant, facilitator, observer)
*
Please Select
Participant
Facilitator
Observer
Other
Filming Details and Purpose: Filming will take place during the Healthcare Design Thinking Lab sessions. Footage may be used for educational, training, research, and promotional purposes by the organizing institution. Please read the full consent information below before agreeing.
Signature (please sign to confirm your consent)
*
Date of Consent
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
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