SHARE YOUR ATSU-CGHS LIFE MOMENT
HIPAA Privacy Rules
By checking this box, you are granting permission and consent to A.T. Still University (ATSU) for the use of the attached photograph(s) for presentation under any legal condition, including but not limited to publicity, copyright purposes, illustration, advertising, web content, and social media use, including permission to tag you in social media posts related to your submitted story. All submissions are subject to be used on social platforms, but not guaranteed.
If another individual is prominently featured in your picture, please provide a written statement or video recording stating their name and giving permission to use the image and publish their ATSU-CGHS Life Moment. The record will only be saved for compliance purposes and will not be published.
“I, [their name], give permission for [your name] to publish my photo online with my ATSU-CGHS Life Moment.”
