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1. Patient Information: Essential identifying information including full name, date of birth, address, insurance details, and patient ID number
2. Healthcare Provider Information: Details of the medical facility, treating physician(s), and relevant department
3. Nature of Authorization: Clear description of the medical procedures, treatments, or information access being authorized
4. Scope of Authorization: Specific details about what is being authorized, including any limitations or restrictions
5. Duration of Authorization: Time period for which the authorization is valid, including start and end dates if applicable
6. Data Protection Declaration: Statement regarding the handling and protection of medical data in accordance with Swiss data protection laws
7. Patient Rights Declaration: Statement of patient rights including right to revoke authorization and access medical records
8. Signature Block: Space for patient or authorized representative signature, date, and witness signature if required
1. Emergency Contact Authorization: Additional section for designating emergency contacts who may receive medical information or make decisions
2. Specific Procedure Details: Detailed information about specific medical procedures when the authorization is for particular treatments
3. Translation Declaration: Required when the form is provided in multiple languages or when translation services were used
4. Mental Capacity Declaration: Required when there are questions about the patient's capacity to provide informed consent
5. Guardian/Representative Authority: Required when someone other than the patient is providing authorization
6. Research Participation: Required when the authorization includes consent for research or teaching purposes
1. List of Authorized Procedures: Detailed list of specific medical procedures or treatments being authorized
2. List of Authorized Recipients: List of healthcare providers or institutions authorized to receive medical information
3. Patient Rights Information Sheet: Detailed explanation of patient rights under Swiss law
4. Data Protection Information: Detailed information about data handling practices and patient privacy rights
5. Cost Information: If applicable, breakdown of expected costs and insurance coverage
Healthcare
Medical Services
Hospitals
Private Clinics
Insurance
Pharmaceutical
Medical Research
Elder Care
Mental Health Services
Rehabilitation Services
Emergency Medical Services
Outpatient Care
Legal
Compliance
Medical Administration
Patient Services
Risk Management
Quality Assurance
Medical Records
Front Desk
Patient Registration
Clinical Operations
Privacy and Data Protection
Medical Director
Hospital Administrator
Clinic Manager
Physician
Nurse Practitioner
Legal Counsel
Compliance Officer
Patient Rights Advocate
Medical Records Manager
Risk Manager
Privacy Officer
Healthcare Administrator
Insurance Coordinator
Medical Secretary
Admissions Coordinator
Quality Assurance Manager
Patient Services Director
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ұԾ’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
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We do not train on your data; ұԾ’s AI improves independently
All data stored on Genie is private to your organisation
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Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it


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