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Consent Form Notice to Facility for Authorized Electronic Monitoring Mobile App

The Consent Form Notice to Facility for Authorized Electronic Monitoring mobile app offers a simple way to manage electronic monitoring consent using a smartphone or tablet. Designed for facilities that utilize electronic surveillance, the app helps ensure that employees, residents and visitors understand their rights when it comes to recording devices and video surveillance.

Gaining electronic monitoring consent is required and an important step in consensual monitoring that must be followed whenever conversations and images of employees, visitors or residents are captured. Once the informed consent form has been completed, the app saves the results electronically for your records.

This informed consent for electronic monitoring template is great for law enforcement officials, medical officials, and care facility supervisors who use a surveillance camera or audio recording.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Consent Form Notice to Facility for Authorized Electronic Monitoring Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    Consent Form Notice to Facility for Authorized Electronic Monitoring

  • Ico textbox

    I, (name of resident)

  • Ico statictext

    OR

  • Ico textbox

    I, (name of resident representative)

  • Ico textbox

    on behalf of (name of resident)

  • Ico textbox

    wish to conduct authorized electronic monitoring in room number/location

  • Ico statictext

    in accordance with State Statutes.

  • Ico dropdown

    Is the monitoring device a video surveillance camera?

  • Ico dropdown

    Does the monitoring device include audio recording?

  • Ico statictext

    This form may be signed only by the resident or the guardian or legal representative of the resid...

  • Ico signature

    Signature

  • Ico dropdown

    Title

  • Ico date

    Date

  • Ico textbox

    Facility Name

  • Ico multiline

    Address

  • Ico signature

    Signature-Facility Representative

  • Ico date

    Date

  • Ico statictext

    The purpose of this form is to:

  • Ico statictext

    ).

  • Ico statictext

    ).

  • ...and More!

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