I, ___________________________permit the Pakistan Association of Dermatologists (PAD) to obtain photographs of myself for educational, medical, scientific, or research purposes.
I agree that the photographs and information relating to my case may be published or used for purposes which the PAD deems proper. These uses may include lectures and professional journals. However, I shall not be identified by name in any such publication or use. I understand that in some cases my facial features may be visible and/ or recognizable.
Photographs shall remain the property of the PAD.
I hereby release the PAD, their personnel, and any other persons participating in my care or dealing with the photographs from any and all liability which may or could arise from the taking or use of such photographs.