Patient photo consent

Clinical photography will be taken to assist in your care. 

This includes before-and-after photos/videos in the clinic or theatre and intra-operative photos/videos during surgery.

By signing this form, you permit these images to become part of your confidential medical records at Rughani Plastic Surgery for assessment and treatment purposes. 

All images/recordings will be securely stored by Dr Milap Rughani / Rughani Plastic Surgery.

PATIENT DECLARATION 

By writing my details below I grant consent for Dr. Milap Rughani & Rughani Plastic Surgery to use pre, intra and post-operative photographs in the following instances:

• Marketing purposes: Website, social media and print adverting 
• Education purposes: teaching, research and patient education

Patients will be given the opportunity to view their images prior to publication and have the right to refuse publication