Baby Announcement Consent Form

This form is to be used by parent's who have recently had a baby at the Leongatha Hospital and
is subject to approval before publishing.

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A confirmation email will be sent to this email.

I consent to the photo uploaded on this form to be distributed as follows:  (please tick one or more)

GSHS Website

GSHS Facebook Pages

The Sentinel Times Newspaper

The Great Southern Star Newspaper

The display board located in the Maternity Ward at the Leongatha Hospital

Upload Photo

Please don't reduce file size, unless it's over 5mb

I confirm the information contained in this form is true and correct and that I am the parent of the aforementioned baby born at Leongatha Hospital.

If you have any questions or concerns in relation to this form, please email jodie.duckworth@gshs.com.au