Get Appendix A The Johns Hopkins Consent To Create And Use Images Bb

This guide provides clear and supportive instructions for users on how to fill out the Appendix A The Johns Hopkins Consent To Create And Use Images Bb form online. It ensures that you fully understand each component of the document and how to complete it correctly.

Follow the steps to successfully complete the consent form online.

1. Click the ‘Get Form’ button to access the consent form and open it for completion.
2. Begin by filling in the patient’s name, including first name, middle initial (if applicable), and last name.
3. Insert the medical record number, date of birth, and telephone number in the appropriate fields.
4. Read the Johns Hopkins Imaging and Recording Patient Education Guide provided on the back of the form, ensuring you understand the content.
5. Initial next to each permission section where indicated, agreeing or disagreeing to the terms for using your images and recordings.
6. For each permission section, specify any authorized non-Johns Hopkins persons or entities where required.
7. If applicable, provide details about the intended use of your identifiable images and recordings for external purposes.
8. Check the box to acknowledge whether Johns Hopkins will receive financial or non-financial compensation in exchange for your images and recordings.
9. Provide your signature and date to confirm your consent, ensuring that all fields are filled out accurately.
10. If you are signing on behalf of the patient, complete the representative section, including your relationship to the patient, and attach proof of authority.
11. Once you have filled out all sections, save your changes, and use the options available to download, print, or share the completed form as needed.

Complete your consent form online today to ensure your rights and preferences are respected.