The Medical Release Form is a crucial document in Austrian healthcare settings, required whenever patient medical information needs to be shared between healthcare providers or released to authorized parties. This document ensures compliance with Austrian medical privacy laws, including the Ärztegesetz and Krankenanstaltengesetz, as well as EU GDPR requirements. The form is essential for maintaining patient privacy while facilitating necessary medical information transfer between healthcare providers, insurance companies, or other authorized recipients. It must be used when sharing any patient medical records, test results, treatment histories, or other protected health information. The document includes specific provisions for patient identification, detailed scope of information to be released, duration of authorization, and clear statements of patient rights under Austrian law.
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1. Patient Information: Complete identification details of the patient including full name, date of birth, address, insurance number, and contact information
2. Healthcare Provider Information: Details of the healthcare provider/facility requesting the release, including name, address, and registration numbers
3. Scope of Release: Specific description of medical information to be released, including time period covered and types of records
4. Purpose of Disclosure: Clear statement of the reason for releasing medical information
5. Authorization Statement: Formal declaration of consent for release of medical information, including acknowledgment of understanding
6. Duration of Authorization: Specification of how long the authorization remains valid
7. Rights and Notices: Statement of patient rights including right to revoke authorization and receive copies
8. Signatures: Spaces for patient signature, date, and witness signature if required
1. Special Categories of Information: Additional authorization for sensitive information such as mental health records, HIV status, or genetic information
2. Minor/Guardian Authorization: Required when the patient is a minor or has a legal guardian
3. Electronic Communication Consent: Optional authorization for transmission of medical information via electronic means
4. Research Authorization: Additional consent for use of medical information in research studies
5. Language Assistance: Confirmation of translation or interpretation services if the patient's primary language is not German
1. Detailed Record List: Itemized list of specific medical records to be released
2. Privacy Notice: Detailed information about privacy rights and data protection under Austrian law and GDPR
3. Authorized Recipients: List of specific individuals or organizations authorized to receive the medical information
4. Revocation Form: Template form for future revocation of the authorization if needed
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Medical Services
Hospital Administration
Insurance
Pharmaceuticals
Medical Research
Elder Care
Mental Health Services
Rehabilitation Services
Public Health
Relevant Teams
Legal
Compliance
Medical Records
Patient Administration
Risk Management
Data Protection
Quality Assurance
Patient Services
Medical Administration
Insurance Coordination
Relevant Roles
Medical Doctor
Hospital Administrator
Clinic Manager
Medical Records Officer
Healthcare Compliance Officer
Legal Counsel
Privacy Officer
Insurance Claims Manager
Medical Secretary
Practice Manager
Healthcare Risk Manager
Data Protection Officer
Patient Relations Coordinator
Medical Research Coordinator
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