Deed of Consent

Interview/Quotation/Personal Image Consent

of address: hereby acknowledge and consent to:

1. ResMed recording and transcribing this interview / story / quotation.

2. ResMed using my story or testimonial in [place an acceptance tick in the box(es)] –

RealSleep Website
SnoozeNewz Patient Newsletter
RealSleep Patient Newsletter
ResMedica Clinical Newsletter
ResMed programs of product training and education
ResMed marketing and promotional programs

3. Representations of me (e.g. photographs and other images) being stored, retrieved, reproduced, published, distributed and transmitted in any form or by any means whether electronic, mechanical, or otherwise (including photocopy, recording, printing, photographic, internet) by the ResMed Group for the purposes of clinical and public education, product training, marketing and promotion programs. 

ResMed may make reference to my full name in marketing publications and promotional programs    
ResMed may make reference only to my first name in marketing publications and promotional programs    
ResMed may not make reference to my name (part or full) in marketing publications and promotional programs  

This consent will last for a period of years or until I inform ResMed, in writing, of my intention to terminate this marketing and promotional relationship with the company.

If you have any questions about this form, please call us free on 0800 9177071

Executed as a deed.

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