Consent form

The Ambulance Staff Charity (TASC) produces a range of communication resources to raise awareness of the charity and our services, as well as issues within the ambulance community sector.

We like to share the stories of real people who are using our services and supporting our work in our communications as it helps to demonstrate the difference our work is making. Stories can be in the form of comments, case studies, images, video or audio.


Make a difference
By completing the form below, you give us permission to use your quote/story/images /video in our communications. You can update or remove your consent at any time by contacting: 

We will not pass the details recorded on this form on to any other organisation without your permission.

Consent form

    Your details

    How we use your story/image/video/audio

    Please select all the options below where you consent for your story to be used.

    Remaining anonymous

    You can choose to have your real name published with your story/images or remain anonymous, in which case, we’ll use a false name for you.

    Social media

    If you are on social media and are happy for your story/images/video to be linked to your social media account, please include your profile name/handle below.

    Giving permission

    Please sign this form to show you are happy to give permission for your quote, story or images to be used by The Ambulance Staff Charity for the purposes outlined above. Your quote, story or images will be used and stored for three years, unless you ask us to stop using it before then. After three years, we will get back in touch with you to check if you’re still happy for us to use your story and/or images.

    If you’re under 18 years old, this consent form must be signed by you and your parent/guardian.

    If you have any questions about this form, please contact the Communications Team.