TX HHS Form 0067. Consent by Roommate for Authorized Electronic Monitoring

The TX HHS Form 0067, Consent by Roommate for Authorized Electronic Monitoring, is a crucial document issued by Texas Health and Human Services (HHS). This form allows a roommate or guardian to consent to electronic monitoring of a resident's room, as permitted under Chapter 242 and 247 of the Texas Health and Safety Code.

This form is designed for use in situations where authorized electronic monitoring is requested, and it provides a means for residents or their guardians to release any civil liability related to privacy rights. The document includes fields for signature, date, and optional restrictions on the use of audio electronic monitoring devices.

The TX HHS Form 0067 is an essential tool for ensuring compliance with Texas laws and regulations governing electronic monitoring in long-term care facilities. As a critical component of the authorization process, this form helps to protect the privacy rights of residents while also facilitating the implementation of necessary restrictions on electronic monitoring use.