Group Portrait Request Form Please complete the form below, required fields = * PLEASE NOTE: Standard delivery for photos is 3 business daysCONTACT 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: 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 photos:* Where will these group photos be used?* UF Health/department website Other Please list all places where these photos will be published:How many people will be in the main group photo? In addition to a main group photo, will smaller group photos also be needed while everyone is there? yes no How many additional group photos will be needed? Please list the different groups: SCHEDULINGHas a suggested shoot date or date range already been discussed?* yes, specific date yes, date range no Date Requested* MM slash DD slash YYYY Date Range Requested* Requested Start Time* : Hours Minutes AM PM AM/PM LOCATIONIs there a specific location these photos need to be taken? yes no, open to suggestions Building 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 INFORMATIONProject 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 and complete 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:
