TX HHS Form 8626. Media Release – Authorization to Photograph or Record a Resident of a Nursing or Assisted Living Facility

The TX HHS Form 8626, "Media Release – Authorization to Photograph or Record a Resident of a Nursing or Assisted Living Facility," is used to obtain permission from residents to photograph or record them for program development, reports, education, and promotion purposes. This form helps solve the problem of ensuring that individuals in nursing or assisted living facilities understand their rights and can provide informed consent before being photographed or recorded.

This authorization grants Texas Health and Human Services (HHS) and the State Long-Term Care Ombudsman Program permission to photograph, audio and video record the individual for the purposes stated above. The form also includes provisions for publishing and publicly exhibiting the photographs, audio and video recordings in any lawful and legitimate manner.

The key feature of this form is that it allows individuals to grant or refuse permission to be photographed or recorded, and they can revoke their authorization at any time by delivering a written and signed statement to the department or program. This form should be used when obtaining consent from residents of nursing or assisted living facilities for media purposes.