File:Angular cheilitis1.jpg

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Original file(1,939 × 1,077 pixels, file size: 1.35 MB, MIME type: image/jpeg)

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English: Photograph of bilateral angular cheilitis in an elderly individual with false teeth, iron deficiency anemia and xerostomia

This patient signed a consent form a blank copy of which is pasted below:

Consent Form for Clinical Photography • Your clinician would like to take a photograph

• The image may be used for teaching purposes in a healthcare environment (e.g. a lecture or teaching session with students or junior doctors), in presentations for medical conferences, in professional medical publications (including journals and textbooks), or in websites (e.g. medical articles on Wikipedia under the Creative Commons Attribution-Share Alike 3.0 Unported copyright license*)

• The image will be taken on a mobile device and then promptly transferred to a secure hard drive along with an electronic copy of this form to be stored for reference

• You will NEVER be personally identifiable from the image, and you can view it after it has been taken to check you are happy with it

• Your personal information, such as name and address will NEVER be disclosed with the image. Very general details, such as your rough age and gender may be disclosed. Some medical details about what is shown in the image may also be disclosed, e.g. the diagnosis or appropriate terminology describing the appearance

I understand and consent to the above

Patient name ………………………………………… Signed (patient / parent / legal guardian) ………………………………………… Signed (clinician) ………………………………………… Date …………………………………………

CC BY-SA 3.0 for details please see:

https://creativecommons.org/licenses/by-sa/3.0/
Date
Source Own work
Author Matthew Ferguson 57

Licensing[edit]

I, the copyright holder of this work, hereby publish it under the following license:
w:en:Creative Commons

attribution share alike

This file is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.
You are free:
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  • to remix – to adapt the work
Under the following conditions:
  • attribution – You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • share alike – If you remix, transform, or build upon the material, you must distribute your contributions under the same or compatible license as the original.

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Date/TimeThumbnailDimensionsUserComment
current20:41, 18 December 2015Thumbnail for version as of 20:41, 18 December 20151,939 × 1,077 (1.35 MB)Matthew Ferguson 57 (talk | contribs)User created page with UploadWizard

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