Consent Form View in PDF format (7 K)

 

I am willing for my child	..............................................
Date of birth	/        /
Hospital registration number	..............................................

 
photographs to be used for the purpose of the Journal 'Images in Paediatric Cardiology' . I understand that this consent is solely for the use specified above, and that my consent will be sought for any other uses of these photographs.
 

Signed and dated by guardian/s of above individual

..............................................

    www.impaedcard.com