Permission To Discuss Medical Information Form

Permission To Discuss Medical Information Form Template for England and Wales

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Key Requirements PROMPT example:

"I need a Permission To Discuss Medical Information Form that allows my elderly mother's doctors to share her medical information with me and my sister for the next 12 months, starting from January 2025, with specific provisions for emergency situations."

Document background

The Permission To Discuss Medical Information Form is essential in healthcare settings across England and Wales where patient confidentiality must be maintained while enabling necessary information sharing. This document becomes necessary when patients need to authorize healthcare providers to discuss their medical information with family members, carers, or other healthcare professionals. It ensures compliance with data protection legislation, including UK GDPR and the Data Protection Act 2018, while providing clear documentation of the patient's consent. The form specifies the scope of information that can be shared, the duration of the authorization, and identifies authorized recipients.

Suggested Sections

1. Patient Information: Full name, date of birth, address, NHS number, contact details

2. Healthcare Provider Details: Name and details of medical practice/hospital/healthcare provider

3. Authorized Recipients: Details of individuals/organizations permitted to receive medical information

4. Scope of Authorization: Specific information authorized for disclosure

5. Duration: Time period for which authorization is valid

6. Patient Declaration: Confirmation of understanding and consent

Optional Sections

1. Third Party Authorization: Used when someone other than patient is giving authorization, such as for minors or individuals lacking capacity

2. Specific Exclusions: Used when patient wants to restrict access to certain information

3. Emergency Contact: Used when additional contact point is needed

Suggested Schedules

1. Proof of Identity: Copies of identification documents

2. Power of Attorney: If applicable, documentation proving authority to act on patient's behalf

3. Additional Medical Details: Any specific medical information references or categories

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

alex.den.21@genieai.co

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Let's create your Permission To Discuss Medical Information Form

Authors

Alex Denne

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