Permission to use clinical photographs

We will never use your clinical photos for any purpose other than your clinical management unless you have given express written permission. You do not need to complete this form for your clinic registration process.

Protecting your privacy

We would like to use your photos to educate current and prospective patients of Spot Check Clinic. Your photos show a good example of the results of treatment and/or a particular type of mole, skin cancer or other skin lesion or condition. Even if you can’t be identified from the photo(s), we want to make sure that you know what image(s) we would like to share and how we’ll use the photo(s). The form documents that you understand this and allow us to use this information about you.