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 that helps resolve issues related to privacy rights in shared living spaces. This form enables roommates or legal representatives to grant consent for electronic monitoring devices to be used in the facility, as per Texas Health and Safety Code Chapter 242 and 247.

This form requires specific information from the person signing on behalf of the resident, including their name, date, and a statement releasing them from civil liability for any potential privacy rights violations. The document also outlines conditions for authorized electronic monitoring, such as restrictions on video surveillance cameras or audio devices. Furthermore, it emphasizes that the implementation of these restrictions is the responsibility of the person signing this form.

The TX HHS Form 0067 is typically used in situations where a resident has requested electronic monitoring and another roommate or legal representative needs to provide consent. Key points to note include:

• Only roommates, guardians, or legal representatives can sign this form.
• The form must be signed by someone on behalf of the resident who has requested electronic monitoring.
• The use of audio devices is prohibited unless specified circumstances apply.