STORY SUBMISSION CONSENT & RELEASE
Last Updated: June 22, 2026
Purpose
The Healthcare Accountability Initiative relies on personal stories to educate the public, advocate for legislative reform, promote patient safety, and advance healthcare accountability.
By submitting a story, testimonial, photograph, video, written statement, or related materials (“Submission”), you acknowledge and agree to the following:
Voluntary Submission
I understand that my participation is entirely voluntary.
I am choosing to share my experiences, opinions, and personal story with the Healthcare Accountability Initiative of my own free will.
Permission to Use My Story
I grant the Healthcare Accountability Initiative a non-exclusive, perpetual, irrevocable, worldwide, royalty-free license to use, reproduce, publish, distribute, display, edit, adapt, summarize, quote, and share my Submission.
This permission includes use in:
● The organization’s website
● Social media platforms
● Legislative advocacy materials
● Public awareness campaigns
● Educational materials
● Press releases
● News media outreach
●Printed materialsFundraising materials
● Public presentations and events
Editing and Formatting
I understand that my Submission may be edited for length, clarity, grammar, formatting, or legal compliance while preserving the overall substance of my story.
No Compensation
I understand that I will not receive compensation, royalties, fees, or other payment for the use of my Submission.
Accuracy of Information
I represent that, to the best of my knowledge, the information I provide is truthful and accurate.]
Privacy Considerations
I understand that information I voluntarily provide may become publicly available if my story is published or shared.
I acknowledge that publication may identify me by name unless I specifically request anonymity and such request is approved by the Healthcare Accountability Initiative.
Right to Decline Publication
The Healthcare Accountability Initiative reserves the right, in its sole discretion, to decline, delay, edit, or remove any Submission.
Medical and Legal Information
I understand that the Healthcare Accountability Initiative does not provide medical advice, legal advice, or legal representation.
Release of Claims
To the fullest extent permitted by law, I release and hold harmless the Healthcare Accountability Initiative, its directors, officers, volunteers, affiliates, representatives, and partners from any claims arising from the authorized use of my Submission.
Consent
By submitting my story, I acknowledge that I have read, understood, and agreed to this Consent & Release.
If submitting on behalf of another individual, I represent that I have legal authority to do so.
