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Get Patient Video Release Form

S form is NOT required for photos or videos of patients used for the purposes of treatment or diagnosis, where the photo and/or video becomes part of the patient s medical record and is not used for any other purpose. Photography/Videography Release: I authorize the University of North Carolina Health Care System ( UNC HCS ) to take photographs and/or videos, or to allow third parties to take photographs and/or videos, of for the following uses: patient nam.

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