I hereby authorize the taking of clinical photographs depicting my injury for purposes of medical documentation, evaluation, and ongoing treatment. I understand that these images will form part of my confidential medical record and will be securely stored in accordance with applicable privacy laws and institutional policies.
I acknowledge that the photographs will be used solely for diagnostic, therapeutic, or quality improvement purposes and will not be released or used for any other purpose without my explicit written authorization, except as required by law.
By signing, I voluntarily consent to the clinical photography of my injury for the purposes described above.
