Nursing Home Activity Recording Consent Form
About this free form template

Nursing Home Activity Recording Consent Form

Caring for residents in nursing homes and memory care facilities requires balancing dignity, safety, and family connection. This Nursing Home Activity Recording Consent Form helps care facilities obtain clear, documented permission from residents and their families for recording activities, therapies, and daily moments.

Whether you're documenting memory care progress, capturing recreational activities, or creating keepsakes for families, this form ensures you have proper authorization while respecting resident privacy and autonomy. It includes guardian consent provisions, viewing restrictions, and specific use-case permissions that protect everyone involved.

Why nursing homes need a recording consent form

Modern senior care facilities often use photo and video documentation to:

  • Share meaningful moments with distant family members
  • Document therapy progress and cognitive assessments
  • Create memory books and celebration videos
  • Train staff on best practices and person-centered care
  • Showcase facility activities for prospective families

Without clear consent, recording activities can create privacy concerns, legal complications, and family disputes. This template helps your facility establish transparent policies that honor resident dignity while fostering family engagement.

What this template includes

This form covers all essential elements of recording consent for senior care:

  • Resident and family authorization with guardian consent options
  • Specific recording types (photos, videos, audio, live streaming)
  • Purpose restrictions controlling how media can be used
  • Authorized viewer limitations to protect privacy
  • Memory care considerations for residents with cognitive decline
  • Dignity preservation clauses ensuring respectful documentation
  • Withdrawal rights allowing consent to be revoked
  • Duration and review periods for ongoing authorization

The form is designed with warmth and clarity, making it accessible for family members during what can be an emotional time while maintaining the legal protection your facility needs.

How Paperform makes consent collection easier

With Paperform, your nursing home can collect recording consent digitally or in person, store responses securely, and keep families informed throughout the process:

  • Conditional logic shows different questions based on resident capacity and guardian status
  • Papersign integration (papersign.com) lets families add legally binding eSignatures remotely or during admission
  • Secure storage keeps consent forms organized with SOC 2 compliance
  • Automated confirmations send families a copy of their signed consent immediately
  • Easy updates when authorization changes or new activities are planned

For facilities managing multiple consents across different programs, Stepper (stepper.io) can automate your workflow—routing signed forms to care coordinators, updating resident files, notifying activity directors of restrictions, and scheduling annual consent reviews.

Trusted by senior care facilities nationwide, this template helps you honor resident dignity while fostering family connection through thoughtful, authorized documentation.

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suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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