TX HHS Form 4205. Consent by Foster Parents or Medical Consenters for Health Passport

The TX HHS Form 4205, Consent by Foster Parents or Medical Consenter for Health Passport, is used to obtain consent from foster parents or medical consenters for the release of health-related information about a child in their care. This form helps solve the problem of ensuring that children's health information is accessible to healthcare providers and medical consenters while they are in foster care.

This form is typically filled out by foster parents or medical consenters who have received training on the Health Passport system, an electronic health information system created by the Texas Health and Human Services Commission (HHSC). The form requires the consenter to provide their name, child's name, and a statement indicating that they understand the purpose of the Health Passport system. They must also indicate whether they consent to the release of specific records, including services pages from their child's Individualized Family Service Plan (IFSP), which contains information about their child's developmental functioning, health, and medical information.

The form highlights key features such as the voluntary nature of the consent, the right to refuse to sign, and the expiration date for new releases. It also emphasizes the importance of understanding that the release of records will make them available to healthcare providers and medical consenters entitled to review such records under specific statutes and rules. Key points include:

• The form is used by foster parents or medical consenters to obtain consent for the release of health-related information about a child in their care.
• The form requires consenter's name, child's name, and statement indicating understanding of the Health Passport system.
• Consent can be withdrawn at any time except for actions already taken.