Patient Story Agreement

This is an agreement between me and The Vestibular Disorders Association (VeDA) with offices at 5018 NE 15^th Ave., Portland, OR and is effective starting January 1, 2023.

I understand that VeDA is preparing, writing, and will distribute a letter and potentially other related works on the subject of vestibular health conditions.

I have agreed to share my vestibular journey through written and/or verbal communication and to provide information and other materials to be used in connection with the letter, including my personal experiences and opinions, medical information, remarks and recollections, as well as photographs, self-videos and documents that I may choose to provide. I understand that some or all of the materials may not end up being used.

I have agreed that:

1. I will review and approve one final draft.
2. I will provide input within an agreed-upon timeline.
3. I cannot request further changes after the initial approved draft.
4. VeDA can edit the story at any time, barring major changes to the facts and character represented in the approved draft.
5. Provide 4-10 photos.
6. VeDA can publish and distribute the story in any format, at any time
7. VeDA maintains creative control for the design and format of the project.