AskTheHIVNurse/Talk2TheHIVNurse photo campaign

AskTheHIVNurse/Talk2TheHIVNurse campaign
Please upload your photo here:*

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Name

First NameLast Name
Do you have:

a Twitter accounta Facebook accountan Instagram account
Do you want to be tagged when we upload your photo?*

YesNo
If yes, please tell us your profile name:
Organisation
Job Title
By submitting this form you give NHIVNA permission to use your photo and your answers and/or elements of your answer for the purposes of "AskTheHIVNurse / Talk2TheHIVNurse" campaign.

The campaign will include presence in social media (indicatively but not limited to: facebook, twitter, instagram, etc.), on the NHIVNA website and/or a website built for the above mentioned campaign, in presentations, and other promotional work.

You have the right at any moment to ask us to remove your photo from the campaign by sending a request to the email address: AskTheHIVNurse@gmail.com
Should be Empty:

AskTheHIVNurse/Talk2TheHIVNurse campaign