Authorisation For Disclosure Of Health Information Form

Authorisation For Disclosure Of Health Information Form for the United Kingdom

Authorisation For Disclosure Of Health Information Form Template for England and Wales

This is a legally binding document used in England and Wales that enables patients or their authorized representatives to give formal permission for the disclosure of their health information to specified parties. The form complies with UK GDPR, Data Protection Act 2018, and other relevant healthcare privacy legislation. It includes detailed specifications about what information can be shared, with whom, and for what duration, while incorporating necessary safeguards to protect patient confidentiality and data protection rights.

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What is a Authorisation For Disclosure Of Health Information Form?

The Authorisation For Disclosure Of Health Information Form is a critical document used in England and Wales to ensure compliant sharing of sensitive medical information. It is required whenever protected health information needs to be shared with third parties outside of direct healthcare provision or other statutory exemptions. The form serves as evidence of explicit consent under UK GDPR and includes specific details about the scope of information to be shared, the duration of the authorization, and the intended recipients. This document is particularly important in maintaining patient privacy rights while facilitating necessary information sharing in healthcare and related sectors.

What sections should be included in a Authorisation For Disclosure Of Health Information Form?

1. Patient Information: Full name, date of birth, address, NHS number, contact details of the patient whose records are being requested

2. Healthcare Provider Details: Name, address and contact information of the healthcare provider or organization holding the medical records

3. Scope of Disclosure: Detailed specification of what medical information is to be disclosed, including relevant time periods and types of records

4. Recipient Information: Details of the person or organization authorized to receive the medical information

5. Duration of Authorization: Specific time period for which this authorization remains valid

6. Patient Declaration: Patient's confirmation of understanding and explicit consent for the disclosure

What sections are optional to include in a Authorisation For Disclosure Of Health Information Form?

1. Representative Authorization: Section for cases where someone other than the patient is authorizing disclosure (e.g., legal representative or power of attorney)

2. Specific Exclusions: Section detailing any specific information the patient wishes to exclude from the disclosure

3. Purpose of Disclosure: Section specifying the reason for requesting the information disclosure

What schedules should be included in a Authorisation For Disclosure Of Health Information Form?

1. Proof of Identity: Schedule for attaching copies of required identification documents

2. Legal Authority Documentation: Schedule for attaching power of attorney documentation or court orders where applicable

3. Records Request Specification: Detailed schedule listing specific records being requested

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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What is a Authorisation For Disclosure Of Health Information Form?

What sections should be included in a Authorisation For Disclosure Of Health Information Form?

What sections are optional to include in a Authorisation For Disclosure Of Health Information Form?

What schedules should be included in a Authorisation For Disclosure Of Health Information Form?

Authors

Alex Denne

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