All-Ireland Midiwfery Network Photo Consent Form

We are excited to showcase and make visible the important work of midwives in caring for babies, women and their families. To support the work of the All-Ireland Midwifery Network, including our promotional, digital resources and our research projects for example “Proud to be a midwife”, we kindly request your permission to use the photos/image – Please complete this form.

Name *

First

Last

Email of Individual *

Role (Please select): *

Midwife
Woman
Birthing Partner
Other(Midwifery supporting professionals)

Photo Upload *

Click or drag files to this area to upload. You can upload up to 10 files.

Please ensure the photo is either in png or jpg format for successful upload.

Photo Details (Please provide a brief description or the photo number(s) for each image you are consenting to share): *

Consent and Agreement *

I consent to the following terms

By signing this form, I confirm that:
1. I give permission for the All-Ireland Midwifery Network (AIMN) to use the above- described/numbered photos on their website, social media platforms, research publications, and promotional materials.
2. I understand that the photos may be adapted (but not altered) for use in these contexts, while maintaining respect for the individuals depicted.
3. I confirm that no identifiable places are within the image shared
4. I confirm that I am the individual in the photograph, or I have the necessary authority to grant permission on behalf of the individuals in the photograph.

Date of Agreement *

Contact Information

If you have any questions regarding this consent form, please reach out to: All-Ireland Midwifery Network (AIMN) Email: allirelandmidwiferynetwork@gmail.com. Thank you.