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Your Experience survey

If you have used our Hospice's services, please consider taking some time to inform us of your experience.

Marketing consent for images

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  • Thank you for agreeing to participate in the Hospice's promotional activity

    St Nicholas Hospice Care wishes to use your story and/or images, video or audio for the purposes of promoting and marketing of the Hospice, its services and fundraising events.

    We would like your permission to publish this material now or in the future. This might be in a newspaper, on Facebook, leaflets, on our website, or for promotional/branding items, such as posters, billboards, roller banners or window displays in our shops.

    Before using your photographs, name, quotes, video or audio we need your permission. Please complete this form.

  • Your personal details

    Your details are collected and stored for the purposes of managing the media associated with your consent.
  • Use of your image

  • Declaration

    I understand that:

    The Hospice may use my or child's image, voice, words and name in content distributed on publicly available media (online and offline).

    The Hospice may use my or child's image and name in the production of promotional materials, publications, and article for marketing and publicity purposes.

    I can withdraw consent for this at any time. I can contact or the organisation's Data Protection Officer if I change my mind.

    Images that are already published can be difficult or impossible for St Nicholas Hospice Care to retract from circulation. The following policies are available to me if I wish to read more about the Hospice's policies: Data Protection and Management policy, Media Policy, Consent Policy.

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    Administrative use

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  • This field is for validation purposes and should be left unchanged.