Event Photography Request Form Please complete the form below, required fields = * PLEASE NOTE: Standard delivery for photos is 3 business daysEvent coverage is limited to 30-minutes with delivery of 5-10 images.CONTACT INFORMATIONStaff Member requesting* Email* Enter Email Confirm Email Phone*Format (###)###-###Will you be present at the photoshoot (yes/no)?* yes no If no, please provide information (name, email, cell) for the contact person who will be present: Will you be responsible for the creative discussions (yes/no)?* yes no Is the person responsible for the creative discussions the same person who will be attending the photoshoot (yes/no)?* yes no If no, please provide information (name, email, cell) for the contact person who is responsible for creative discussions: PROJECT INFORMATIONProject Name (aka. Slug):*2-3 words. This will be used for naming the project folders and files so you can find them later in Photoshelter. College, Service Line or Department needing marketing photos:* Will these photos be used internally or externally?* Internal (within the hospital/college) External (for the public) Is there a formal program of the event?* yes no What type of event is this?* Awards Ceremony/Recognition Event Graduation/Commencement Donor Event Poster Session Other What type of event is this?* What is the main way in which the event coverage photos will be used?*Please select all that apply: Print/Online Magazine Story Web Publication/Blog Social Media Use What is the publication where this will be published?* What is the story title?* What website will be this published on?* What social media account will this be published on?* Is there a due date for the materials?* yes no Due date for materials:* MM slash DD slash YYYY Intended Audience* Patients Faculty & Staff Community Students Other If other, please explain:* SCHEDULINGEvent Date* MM slash DD slash YYYY Event Start Time* : Hours Minutes AM PM AM/PM Event End Time* : Hours Minutes AM PM AM/PM Requested Photography Coverage Start Time*Coverage will run for 30 minutes after this time. : Hours Minutes AM PM AM/PM LOCATIONBuilding Name* Address*(What you would use to put into GPS) Room Number* Additional Location Information*Please provide additional directional information so we know how to find the place. (Assume we’ve never been there before.)PHI (PERSONAL HEALTH INFORMATION) CONSENT FORMSAre PHI Forms needed for this photoshoot?* yes no Staff Member Responsible for Obtaining PHI Forms* What is the Purpose of Sharing the PHI? Check all that apply*Check all appropriate uses of these photos Select All Marketing News Media Public Relations Publication (e.g., brochure, online journal, book) Fundraising Not Applicable Remember to check off all boxes when having the PHI form signed by the patient. (As many as possible so that photos can be used for multiple purposes.)ADDITIONAL INFORMATIONDesigner Assigned*Please indicate the designer working on this project so we can connect with them.Selena CarterMary CeceliaMadelyn HyderMichael McAleerThere will be a designer, but they are not assigned yetThere will not be a designerProject Keywords*Please enter relevant keywords separated by commas. These keywords are used in Photoshelter to assist in finding the photos using the search feature.Caption for Photos*This caption will be archived in the metadata of the image. This is 1-2 full sentences that includes: WHO, WHAT, WHEN, WHERE & WHY.Are these photos ONLY for your specific campaign/project and not available to others for future use.* Yes, these are only for my use and cannot be shared No, these images can be shared with others Besides yourself, will anyone else need access to the gallery after the photoshoot?* yes no Please provide each person's email address: Event Coverage Policy*Event coverage is limited to 30 minutes with delivery of 5-10 images. Please understand that due to limited resources and availability, we may not be able to cover events that take place after hours or on weekends. I understand the event coverage limitations.
