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Templates / Forms

WordGDPR

Social Media Consent Form

A Word form asking to use someone’s name or image on social channels. State the accounts and the duration. Platform terms and employment rules still sit with you.

Free

  • Email download link
  • Not legal advice
Preview this template
File name
Social-Media-Consent-Form-pglghy.docx
Format
Word
Opens with
Microsoft Word or another editor that opens .docx
Jurisdiction / regulations named
GDPR
Last catalog update
7 Sept 2026
What you must still do
Put the file on your letterhead, name your tools and roles, and have qualified counsel review it for your processing. These materials are not legal advice and do not certify compliance.
Who it's for
Teams that collect consent or handle data-subject requests.

More in Forms · Also see Policies

Social Media Consent Form

Preview

Sample pages

English. Word file (Social-Media-Consent-Form-pglghy.docx). Excerpts below are copied from this upload.

Placeholders in this file

  • Name of Participant
  • Name of Organization

Excerpt 1

SOCIAL MEDIA CONSENT FORM

I, [Name of Participant], hereby give consent to [Name of Organization] to use and share my name, image, and other relevant personal information on social media platforms for the following purposes: Promoting the organization's services or activities on social media platforms. Sharing information about events or activities related to the organization on social media platforms. Providing educational resources and information related to the organization's services or activities on social media platforms. Other purposes related to the organization's mission and activities on social media platforms.

Excerpt 2

I understand that my personal information may be viewed by a wide audience, including

I understand that my personal information may be viewed by a wide audience, including individuals who are not affiliated with [Name of Organization], and may be shared and reposted by others. I acknowledge that I have read and understand the terms of this consent form, and I give my informed consent for the use of my personal information on social media platforms by [Name of Organization]. Signed: ________________________Witnessed by: _________________________ Date: _________________________Date: _________________________________ (Printed Name of Participant) (Printed Name of Witness)

Text copied from the uploaded file. It is not the complete download.

Overview

A free Word form for healthcare and similar settings where you want written permission before using someone’s story or image on social media. GDPR-aware framing. It does not replace your public privacy notice or clinical confidentiality rules.

License

For one organization's internal use. You may customize the files. You may not resell or redistribute them as products. They are starting documents or training clips, not legal advice, not a certification, and not a guarantee of compliance — have qualified counsel review them for your situation.

What's inside

  • Microsoft Word social-media consent form (free)
  • What will be posted and on which channels
  • Withdrawal and contact details
  • Healthcare-friendly language
  • Instant download

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Social Media Consent Form

Free