Texas department of aging and disability services forms 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the resident in the designated field. Ensure accuracy as this is crucial for identification.
3. If you are filling out the form on behalf of someone else, provide your name in the requestor section.
4. Indicate whether the monitoring device is a video surveillance camera by selecting 'Yes' or 'No'. If 'Yes', specify any conditions under which it may be obstructed.
5. Answer whether the resident resides in a multi-person room by selecting 'Yes' or 'No'. This information is important for compliance with privacy regulations.
6. Finally, ensure that either the resident, guardian, or legal representative signs and dates the form. Circle the appropriate title to clarify who is signing.

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