Media Release Forms
HIPAA Media Release Form
The HIPAA Media Release Form is used anytime you will involve a patient or PHI in an article, photography, or video.
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Digital HIPAA Media Release Form
- Instructions for the Digital HIPAA Media Release Form
- PDF HIPAA Media Release Form
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Instructions for the YSM HIPAA Media Release Form Tool
- First: Get Adobe Sign and email ysm.editor@yale.edu to request access to the HIPAA tool.
- Then: Prepare a file via HIPAA Release Form
General Photo/Video Release form
The General Release form can be used when the shoot is not clinical and there is no PHI involved. For instance, you might use this form if you are taking photographs of a gathering and you want to have release forms for the visitors who were included in the photograph.