St. Louis Children’s Hospital

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Media Consent Forms

To comply with patient confidentiality and HIPAA guidelines, St. Louis Children's Hospital and Washington University School of Medicine require a signed consent form before a child can be photographed at the hospital, or a physician can be interviewed - for internal marketing/communications, or by the news media - in reference to that child's care.
 
Below, please find copies of the consent forms for St. Louis Children's Hospital and Washington University School of Medicine.

Please download the appropriate form(s) as directed by your media relations contact, and sign and return them to the media relations department via fax or mail. Thank you!

St. Louis Children's Hospital Media Relations
600 S. Taylor, Suite 202
St. Louis, MO 63110
fax: 314.286.0420

St. Louis Children's Hospital Media Consent Form

Washington University School of Medicine Media Consent Form

St. Louis Children's Hospital is affiliated with Washington University School of Medicine.

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St. Louis Children's Hospital • One Children's Place • St. Louis, MO • 63110 • 314.454.6000