Consent must be completed with each instance where photographs are requested by a referral
agency coordinator and/or staff in accordance with the purposes of the referral.
This consent is valid on this date:
I give permission to my Iris Family Support Center worker to take photographs as needed to
document the condition of my home and/or family. I understand that these photographs may be used
to:
- Document current conditions and any improvements over time.
- Support the services provided through my referral.
- Be used for training purposes within Iris Family Support Center.
Photographs will be taken only as necessary, based on the specific needs outlined in the referral.
They will not include any identifying features of my home or family members that could reveal our
identity to anyone outside of Iris Family Support Center and the referral agency.