Consent for Media Coverage

  • I do hereby give my permission for Newman Regional Health public relations officials, other designated hospital officials, or employees of local/regional media, to interview, photograph, audio record, video record, use my photograph or image, and use any verbal or electronic communication for the purposes indicated below.
  • Drop files here or
  • Full Name of Patient/Subject
  • By clicking below I submit my authorization and consent

Connect With Us

Newman Regional Health
1201 W 12th Avenue
Emporia, KS 66801
Newman Medical Plaza
1301 W 12th Avenue
Emporia, KS 66801