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Photo, Video, and Recording Consent Forms

In order to comply with various legal requirements, the following applies to photos, videos, and recordings of meetings and seminars posted on the Pitt Pediatrics website, social media, and/or internal video archive services.

General Photos and Videos of Employees

Consent forms are not required by the Chair's Office for photos and videos taken of University of Pittsburgh personnel when in the course of their normal duties of employment.  

However, as a courtesy, employees should be notified verbally that their photo is being taken or a video recording is in progress.

All Recorded Seminars, Conferences, or Meetings Containing Research-Related Content or Protected Health Information

Divisions, centers, institutes, and business units recording a research seminar, conference, or meeting containing research-related content must obtain consent from the presenter through a DocuSign form.

This applies to all presenters who seek to have their presentations recorded and posted internally or externally, including all Pitt and UPMC personnel, and those from other institutions that are guest speakers.

  1. Designate a coordinator within your division, center, institute, or business unit for this consent process.  This person must be employed by Pitt, UPMC, or UPP and may not be the same person as the presenter.
  2. The coordinator initiates the DocuSign form and inputs their name and email address.  Additionally, the coordinator inputs the name and email address of the presenter.
  3. The coordinator completes their designated section of the consent form outlining the purpose for the video and the associated division, center, institute, or business unit.
  4. The DocuSign system will automatically send email notifications to the presenter for his or her signature.
  5. Once the form is completed, DocuSign will email final signed copies to all parties and the Chair's Office.
  6. The Chair's Office will proceed with uploading of footage to the website, social media, or internal video service.

By completing this form and authorizing recording, the presenter warrants that if a patient, minor, or other subject appears in the recorded presentation, he or she has obtained legal consent for their participation and/or protected health information to be discussed.

Photos of Patients or Individuals Under 18 Years of Age

A consent form must be completed by a coordinating faculty member, staff member, or student with the minor child and his or her parent or guardian.  

The consent form must be retained by the coordinating division, center, institute, or business unit and does not need to be sent in to the Chair's Office unless otherwise instructed.

If the minor child is too young to sign his or her signature block, the parent or guardian may do so in the designated block on his or her behalf.

Photos of Patients 18 Years of Age or Older

A consent form must be completed by the patient.  

The consent form must be retained by the coordinating division, center, institute, or business unit and does not need to be sent in to the Chair's Office unless otherwise instructed.

Videos of Patients or Individuals Under 18 Years of Age

All video footage captured of minors and/or patients under 18 years of age requires a consent form through DocuSign prior to the video being placed on the Pitt Pediatrics website, any social media account, or any internal Pitt or UPMC video service.

  1. Designate a coordinator within your division, center, institute, or business unit for this consent process.  This person must be employed by Pitt, UPMC, or UPP.
  2. The coordinator initiates the DocuSign form and inputs their name and email address.  Additionally, the coordinator inputs the name and email address of the minor or patient*, as well as the name and email address of his or her parent or guardian.
  3. The coordinator completes their designated section of the consent form outlining the purpose for the video and the associated division, center, institute, or business unit.
  4. The DocuSign system will automatically send email notifications to the patient and his or her parent or guardian for the necessary signatures.
  5. Once the form is completed, DocuSign will email final signed copies to all parties and the Chair's Office.
  6. The Chair's Office will proceed with uploading of footage to the website, social media, or internal video service.

*If the minor child is too young to sign his or her signature block and/or doesn't have an email address, the coordinator should provide the minor child's name and the email address of the parent or guardian in the "presenter or subject" field.

Videos of Patients 18 Years of Age or Older

All video footage captured of adult patients or individuals requires a consent form through DocuSign prior to the video being placed on the Pitt Pediatrics website, any social media account, or any internal Pitt or UPMC video service.

  1. Designate a coordinator within your division, center, institute, or business unit for this consent process.  This person must be employed by Pitt, UPMC, or UPP.
  2. The coordinator initiates the DocuSign form and inputs their name and email address.  Additionally, the coordinator inputs the name and email address of the patient or subject.
  3. The coordinator completes their designated section of the consent form outlining the purpose for the video and the associated division, center, institute, or business unit.
  4. The DocuSign system will automatically send email notifications to the patient or subject.
  5. Once the form is completed, DocuSign will email final signed copies to all parties and the Chair's Office.
  6. The Chair's Office will proceed with uploading of footage to the website, social media, or internal video service.

FAQs

Is a UPMC consent form sufficient in place of the Pitt Pediatrics-specific consent form?

No. Pitt Pediatrics requires a specific consent form for academic and research related programs.

Why is a UPMC consent form included in the DocuSign envelopes for video participants and meeting/seminar recordings?

The Chair's Office typically uploads footage to two different internal video services, one of which is hosted through UPMC.

What is the difference between "limited use" and "full use" on the Pitt Pediatrics consent form?

The "limited use" option will allow Pitt Pediatrics to use the captured footage for internal use only and does not permit distribution of the footage to the general public. For example, a seminar that is recorded under "limited use" consent will be posted on an internal University of Pittsburgh video streaming service instead of YouTube.

The "full use" option allows Pitt Pediatrics to use the captured footage for any purpose or audience, internal or external to the organization.

Where is video footage under "limited use" published?

In most cases, this footage is published on Microsoft Stream, which is a Microsoft 365 internal video sharing service requiring authentication.  Videos are available to the entire Pitt or UPMC organizations and cannot be limited to specific groups of personnel and/or the Department of Pediatrics.

I have additional questions. Who can I contact for help?

Please contact the Pitt 24/7 Information Technology Help Desk and request they generate a case in the Pediatrics General service queue. A Pitt Pediatrics IT or Chair's Office representative will follow-up with you.