TX HHS Form 1038. Consent for the Use of Audio-Only or Audio-Visual Communication

TX HHS Form 1038. Consent for the Use of Audio-Only or Audio-Visual Communication

The TX HHS Form 1038, Consent for the Use of Audio-Only or Audio-Visual Communication, is a crucial document that facilitates communication between individuals with intellectual and developmental disabilities (LIDDA) and their service coordinators. This form helps solve the problem of ensuring that LIDDA clients provide consent for audio-only or audio-visual communication during service coordination visits.

This form is typically used in situations where LIDDA service coordination visits are required by 26 TAC Chapter 331, Section 331.11(d). The document outlines the necessary information, including the person's address and phone number, as well as their name and title of the LIDDA staff completing the form. Key features include the acknowledgment that this consent form is only for LIDDA service coordination visits, and that refusal to consent will not impact services.

Some key points to note are:

  • This consent form is valid for a specified duration or one year if no duration is specified.
  • The individual may withdraw consent at any time by contacting their assigned service coordinator.
  • A new consent form must be completed at the next in-person service coordination contact if consent is withdrawn.
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SourcePage: 
https://www.hhs.texas.gov/regulations/forms/1000-1999/form-1038-consent-use-audio-only-or-audio-visual-communication