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OSDH Video Forms:

The Photo/Video Release Form below is for people to sign for use of their likeness in a photograph or video for OSDH promotional purposes.

The HIPAA release form is required for the use of the likeness of a client of OSDH who has received medical services from OSDH or for the depiction of someone receiving services such as an employee or anyone else receiving a flu shot etc.

NOTE: All forms are in PDF format. In order to view PDF files, you must download and install the free Adobe (TM) Reader. Complete instructions on downloading and configuring the reader for your system are available at the Adobe (TM) Reader web site.

 

Revised on 2-1-12

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