Royal National Orthopaedic Hospital NHS Trust,
Brockley Hill, Stanmore, Middlesex, HA7 4LP
0208 909 5362
Registered Charity Number 1166129
Share your story
MEDIA CONSENT FORM
RNOH Charity produces a range of communications resources to promote its work. It likes to share the experiences of real people who use the hospital’s services as part of its communications as it helps to demonstrate the difference its work is making to a wider audience. By completing this form, you give the Charity permission to use your story, images, audio and video in its communications.
Please read this form carefully. If there is anything you do not understand, please contact June Heath, Head of Communications, RNOH Charity: june.heath3@nhs.net.
Please indicate in the relevant field below to show you are happy to give permission for your story to be used by RNOH Charity for the purposes outlined above.
Data protection: The information that you provide here will only be used to contact you about sharing your story in our communications work. We will not pass the details recorded on this form to any other organisation without your permission.
Your rights: You have the right to withdraw your consent at any time, in which case film/photography/audio recording of yourself will not be used in future publications but may continue to appear in publications already in circulation. Contact RNOH Charity, Brockley Hill, Stanmore, Middlesex HA7 4LP or by emailing: rnoh.charity@nhs.net
Images of myself captured in the video recordings and/or photographs will be the copyright of RNOH Charity and I understand that I am responsible for informing RNOH Charity in writing if any permission given on this form is to be withdrawn in the future. Please note: images that are published externally on the website or social media may not be able to be removed entirely if you withdraw your consent at a later time.