Photography Request Form Photography Needs - 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: INTENDED USE OR TYPE OF COVERAGEPlease select all that apply* News/Press Release Print Magazine Web Publication Marketing Fundraising Environmental Portraiture for a Publication/Magazine Studio Headshot for Biography Page Architectural/Facility Photography Surgical or Medical Procedure Select/Limited Event Coverage !! Event Coverage Limitations !! Please note: All photography requests for events must meet the requirement guidelines listed on our creative services website and must result in external (public) usage of the photographs. 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.DATE, TIME & LOCATIONDate Requested* MM slash DD slash YYYY If needed, is this date flexible?* yes no If there is flexibility, what is the date range or time period you are looking to schedule?* Requested Start Time* : Hours Minutes AM PM AM/PM Requested End Time* : Hours Minutes AM PM AM/PM Event Start Time* : Hours Minutes AM PM AM/PM Event End Time* : Hours Minutes AM PM AM/PM Requested Photographer Start time for Event Coverage*Coverage will continue for 30 minutes past this time. Please make sure this is the time when we can capture the seminal moments of your event. : Hours Minutes AM PM AM/PM Location Address*Please include full building name, address and room number. Additional Location InformationPlease provide additional location information with specific directions we might need to know. PROJECT INFORMATIONProject Name (aka. Story Slug):*2-3 words Please visit the studio schedule link below to book a headshot session in our studio: https://creativeservices.ufhealth.org/services/photography/#scheduleWill these photos be used internally or externally?* internal (within the hospital/college) external (for the public) Intended Audience* Patients Faculty & Staff Community Students (enrolled or unenrolled) Other (Please explain under "Project Brief") How will the event coverage photos be used?*Please select all that apply: images used for a press release images used for an accompanying story images used for official website or social media use there is a formal program of the event Name of Intended Publication(s)*Please list all: Name or link to Website for Publication*Please list all: Publication deadline*If there is a specific publication/magazine with an immediate need, please list the deadline they have provided. MM slash DD slash YYYY Project Brief*Please provide as much information as possible about your photo need. The more details you provide the better we can understand how we can help.Photo Subject(s)*Full name (please note, if more than one subject, please name them above in the description filed): Title:*Title: College and department:*College and department: Shot List*Please a provide a specific, bulleted/numbered shot list. (EXAMPLE: 1. Portrait of doctor looking at camera. 2. Doctor working in lab. 3. Doctor working in lab with student. 4. Student portrait looking at camera. etc)Photo Samples and/or Creative StylesIs there a past gallery of photos we can view? Or is there a specific "look" you'd like to replicate for this project. 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.NoneSelena CarterMary CeceliaMadelyn HyderMichael McAleerProject Keywords*Please enter relevant keywords separated by commas. These keywords are used for archiving purposes.Caption for Photos*This caption will be archived in the metadata of the image. This is 1-2 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:
