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 a crucial document for individuals residing in these facilities. This form grants permission to photograph or record the resident for various purposes, including program development, reports, education, and promotion.

The authorization allows Texas Health and Human Services (HHS) and the State Long-Term Care Ombudsman Program to publish and publicly exhibit the photographs or recordings in any lawful and legitimate manner. The form also relinquishes all rights, title, and interest in the materials produced, giving HHS and the Ombudsman Program consent to retain, reproduce, and use the material as authorized.

This form is typically used in situations where residents of nursing or assisted living facilities wish to participate in public events, training, education, or local news and promotion. The authorization can be revoked at any time by delivering a written and signed statement to the department or program that originally received the authorization. Key points to note include:

• The resident's right to refuse to sign this authorization without affecting treatment, benefits, or payment processing.
• The purpose of the authorization is for program development, reports, education, and promotion.
• The materials produced are the exclusive property of HHS and the Ombudsman Program.