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1. Use of Photographs/Images: Required when the case report will include clinical photographs, imaging results, or other visual materials

2. Commercial Use Declaration: Needed if there's any possibility of commercial use of the case report or associated data

3. Future Research Use: Include when the data might be used for future research beyond the immediate case report

4. Translation Declaration: Required when the patient's primary language is not the language of the consent form

5. Legal Representative Consent: Necessary when the patient is unable to provide consent themselves or is a minor

6. Genetic Information Use: Required when genetic testing or genetic information will be included in the case report

1. Description of Case Report: Detailed outline of the specific medical case and information to be included in the report

2. Data Protection Information Sheet: Detailed information about data protection measures and patient rights under GDPR

3. Publication Plan: Details about intended publication venues and process

4. Image/Photograph Schedule: List and copies of specific images to be included in the case report, if applicable

5. Contact Information Sheet: Complete contact details for healthcare provider, institution, and data protection officer