Please record a 30-second video in support of the proposed staffing standards for nursing homes. Nursing home owners are pushing back and claiming that these staffing standards are not necessary. Your story can help make the difference.
You have 30 seconds to record your story. Please use the following format:
1. Say your name and your job (CNA, CMA, etc.) and what city you work in.
2. In a sentence or two, explain what better staffing would mean for you and your residents.
These videos will be used for a media campaign supporting the proposed CMS staffing standards for nursing homes. By submitting your video you are consenting to the following:
I give my consent to the Service Employees International Union (SEIU), CTW, CLC, including all its Locals and Affiliates, (collectively, the “Union”) to use and publish information I have provided to the Union. I give the Union my permission to use and publish my name, photograph, videotape and/or any statements I have made to the Union. The Union has my permission to publish this material in print, on the internet, over TV and radio, or through any other media. I waive any right I may have to inspect or approve any finished products incorporating this material. I agree to release the Union from all liability and any claims that I may have arising out of the use, publication or disclosure of this material. If I have provided my photograph and/or videotape, I further grant permission for the Union to copyright this material, and I release the Union from any liability arising from any blurring, distortion, alteration, optical illusion, or composition of my photograph or videotape. I agree to participate in political action with SEIU Local 503.
I have read this form and fully understand the contents of this release.