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Model Release Form

Thank you for helping us!

Blatchfords aims and aspirations, are to help and support people with impaired mobility all over the world. To do this we want to share authentic stories of people who have overcome their mobility challenges and learnt to embrace life using their prosthetic or orthotic device. We are very proud to be an integral part of the amputee community but need your help, by you sharing your stories to help inspire and give hope to others.

Who is completing this form?
Caregiver/Guardian Details...
Patient Details...
And finally...

We need your permission to use this information

At Blatchford we produce a range of materials to tell people about our products and services, including but not limited to stories, quotes, photographs, brochures, exhibition materials, advertising, social media posts, recordings, marketing emails, video and online content (referred to as “Materials”).


By completing this form you agree to allow Blatchford (the “Company”) and its successors, sponsors, employees, distributors and licensees to: (i) copy and reproduce your words, likeness, image, biographical information and personal data in its Materials; and (ii) to share those Materials in any form, for the purposes of marketing the Company’s products and services (the “Purpose”). I acknowledge that any personal data submitted by me will be processed in accordance with Blatchford's Privacy Policy


If you have any questions or concerns, please email information.security@blatchford.co.uk or read our Privacy Policy online.