I {patientsName} GRANT CLEAR CARE PERIODONTAL & IMPLANT CENTRE PERMISSION TO TAKE PHOTOGRAPHS AND/OR VIDEOS OF MY JAW AND TEETH (FULL-FACE SHOTS WILL NOT BE USED) FOR MAINTAINING RECORDS FOR RESEARCH, EDUCATION (LECTURES AND SEMINARS) AND MARKETING MATERIAL (WEBSITES, SOCIAL MEDIA, PRINTED MATERIALS, PATIENT EDUCATION). I UNDERSTAND MY NAME WILL BE KEPT CONFIDENTIAL. IF MY PHOTOGRAPHS AND/OR VIDEOS ARE USED, THEY WILL NOT CONTAIN ANY IDENTIFIABLE INFORMATION.
IMAGES WILL BE STORED IN A SECURED LOCATION AND ONLY AUTHORIZED STAFF WILL HAVE ACCESS TO THEM. THEY WILL BE KEPT AS LONG AS THEY ARE RELEVANT AND AFTER THAT TIME DESTROYED OR ARCHIVED.