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1. Parties: Identifies the healthcare provider/facility and the patient (or legal guardian) who are entering into the agreement
2. Background: Explains the context of social media usage in healthcare and why consent is being sought
3. Definitions: Defines key terms used in the form including 'Social Media', 'Personal Health Information', 'Content', 'Posts', etc.
4. Purpose and Scope: Clearly states the intended use of patient information/images on social media and the platforms where content may be shared
5. Patient Rights: Outlines the patient's rights regarding their information, including right to withdraw consent
6. Consent Declaration: The actual consent statement that the patient agrees to, specifically detailing what they're consenting to
7. Privacy Protection Measures: Details the steps taken to protect patient privacy when sharing content
8. Content Usage Terms: Specifies how the content will be used, duration of use, and any restrictions
9. Signatures: Space for dated signatures of all parties involved
1. Financial Considerations: Include when there's any compensation or financial implications related to the content usage
2. Third-Party Sharing: Include when content might be shared with or used by third parties beyond the primary healthcare provider
3. Geographic Restrictions: Include when content sharing needs to be restricted to specific geographic regions
4. Special Provisions for Minors: Include when the patient is under 18 and requires guardian consent
5. Medical Education Usage: Include when content might be used for medical education purposes
6. Translation Declaration: Include when the form needs to be provided in multiple languages for patient understanding
1. Schedule A - Specific Content Description: Detailed description of the specific content (photos, videos, testimonials) that will be shared
2. Schedule B - Authorized Social Media Platforms: List of specific social media platforms where content may be shared
3. Schedule C - Privacy Protection Protocols: Detailed protocols for protecting patient privacy when sharing content
4. Appendix 1 - Sample Content Layout: Visual examples of how content will be presented on social media
5. Appendix 2 - Withdrawal Form: Template form for withdrawing consent if patient chooses to do so
Healthcare
Medical Services
Hospitals
Clinics
Dental Practices
Cosmetic Surgery
Physical Therapy
Mental Health Services
Telemedicine
Medical Education
Legal
Compliance
Marketing
Social Media
Patient Relations
Medical Administration
Communications
Digital Marketing
Data Protection
Quality Assurance
Medical Director
Hospital Administrator
Clinic Manager
Social Media Manager
Marketing Director
Legal Compliance Officer
Privacy Officer
Patient Relations Manager
Healthcare Marketing Specialist
Medical Communications Officer
Content Manager
Digital Marketing Coordinator
Medical Practice Manager
Healthcare Communications Director
Data Protection Officer
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