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1. Minor Patient Provisions: Additional provisions when the patient is under 18, requiring parental/guardian consent

2. Commercial Use Declaration: Required when content might be used for promotional or commercial purposes

3. Third-Party Sharing: Provisions for sharing with other healthcare providers or organizations

4. Emergency Contact Authorization: Authorization for emergency contacts to modify/withdraw consent if patient becomes incapacitated

5. Language Translation Declaration: When the form is provided in multiple languages or patient requires translation

6. Special Medical Condition Considerations: Additional privacy provisions for sensitive medical conditions

1. Schedule A: Approved Social Media Platforms: List of specific social media platforms where content may be shared and their privacy settings

2. Schedule B: Content Types and Examples: Detailed descriptions and examples of the types of content that may be shared

3. Schedule C: Privacy Protection Protocols: Detailed procedures for protecting patient privacy when posting

4. Appendix 1: Platform-Specific Guidelines: Specific guidelines and restrictions for each social media platform

5. Appendix 2: Image Modification Guidelines: Standards for modifying images to protect patient privacy

6. Appendix 3: Withdrawal Request Form: Standard form for requesting withdrawal of consent