The Medical Release Form For Adults is a vital document in Austrian healthcare administration that enables healthcare providers to legally share patient medical information with authorized parties while maintaining compliance with Austrian healthcare regulations and EU data protection laws. This document is essential when patients need to authorize the sharing of their medical records with other healthcare providers, insurance companies, or designated representatives. It includes specific provisions for data handling under the Austrian Federal Hospitals Act (KAG) and GDPR, clearly outlining the scope of information to be shared, duration of authorization, and patient rights. The form is particularly important in situations involving ongoing medical care, insurance claims, or when coordinating care between multiple healthcare providers.
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1. Patient Information: Full legal name, date of birth, address, and contact information of the patient
2. Healthcare Provider Information: Name and details of the medical facility, hospital, or healthcare provider
3. Medical Information Release Authorization: Specific details about what medical information can be released, including time period covered
4. Purpose of Disclosure: Clear statement of the reason(s) for releasing medical information
5. Recipient Authorization: Details of individuals or organizations authorized to receive the medical information
6. Duration of Authorization: Validity period of the release authorization
7. Patient Rights Statement: Information about the patient's rights regarding the release, including right to revoke
8. Data Protection Notice: GDPR-compliant statement about how the information will be processed and protected
9. Signature Block: Space for patient signature, date, and witness signature if required
1. Emergency Contact Authorization: Optional section for authorizing emergency contacts to receive medical information - used when patient wants to designate specific emergency contacts
2. Specific Treatment Exclusions: Section to list any specific medical information that should NOT be released - used when patient wants to restrict certain information
3. Electronic Communication Consent: Authorization for receiving information via email or other electronic means - used when electronic communication is desired
4. Language Preference: Specification of preferred language for medical communications - used in multilingual settings
5. Medical Representative Authorization: Authorization for a designated representative to make medical decisions - used when patient wants to appoint a healthcare proxy
1. List of Authorized Recipients: Detailed list of all individuals and organizations authorized to receive medical information
2. Specific Medical Records Checklist: Itemized list of specific medical records authorized for release
3. Patient Rights Information Sheet: Detailed explanation of patient rights under Austrian law and GDPR
4. Revocation Form: Form that can be used to revoke the medical release authorization
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Medical Services
Insurance
Pharmaceuticals
Healthcare Technology
Medical Research
Elder Care
Rehabilitation Services
Mental Health Services
Occupational Health
Relevant Teams
Legal
Compliance
Medical Records
Patient Services
Privacy and Data Protection
Quality Assurance
Administrative Services
Clinical Operations
Risk Management
Information Governance
Relevant Roles
Medical Director
Healthcare Administrator
Compliance Officer
Medical Records Manager
Privacy Officer
Healthcare Attorney
Patient Services Coordinator
Clinical Director
Insurance Coordinator
Medical Office Manager
Quality Assurance Manager
Data Protection Officer
Hospital Administrator
Practice Manager
Legal Counsel
Patient Rights Advocate
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