TX HHS Form 5402. Office of Communications – Media Release

The TX HHS Form 5402, Office of Communications – Media Release, is a crucial document for individuals who need to grant permission for their photograph, audio, or video recording by Texas Health and Human Services (HHS) for program development, education, and promotion purposes.

This form is essential when an individual wants to participate in HHS productions, such as events, programs, or activities. The form requires the subject's printed name, contact information, and signature, along with a statement granting permission for their photograph, audio, or video recording. Additionally, the form includes sections for minors and incapacitated adults, which require consent from a parent or guardian.

The TX HHS Form 5402 is designed to provide transparency and control over the use of recorded materials. It allows individuals to revoke their authorization at any time by delivering a written and signed statement to the HHS Office of Communications. This form is an important tool for ensuring that individuals are aware of and agree to the terms of their recorded images being used for various purposes.