Authorization For Disclosure Of Information Form

Authorization For Disclosure Of Information Form Template for Singapore

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Key Requirements PROMPT example:

"I need an Authorization For Disclosure Of Information Form for my medical records to be shared between Singapore General Hospital and my new specialist clinic, starting from March 2025, with specific provisions for sharing diagnostic images and test results only."

Document background

The Authorization For Disclosure Of Information Form is a crucial document in Singapore's data protection framework, designed to facilitate legitimate information sharing while protecting individual privacy rights. This form is required when an organization needs explicit consent to access or share an individual's personal information, whether for healthcare, financial, employment, or other purposes. It ensures compliance with Singapore's Personal Data Protection Act and related regulations, providing clear documentation of consent and specific parameters for information disclosure.

Suggested Sections

1. Authorizing Party Details: Full name, identification, contact information of person giving authorization

2. Recipient Details: Entity/person authorized to receive information

3. Scope of Authorization: Specific information authorized for disclosure

4. Purpose of Disclosure: Clear statement of why information is being disclosed

5. Duration of Authorization: Period for which authorization remains valid

6. Declaration and Signature: Formal authorization statement and signature block

Optional Sections

1. Third Party Recipients: Additional parties with whom information may be shared beyond primary recipient

2. Revocation Process: Process and procedures for withdrawing authorization when disclosure is ongoing

3. Security Measures: Specific data protection requirements and safeguards for handling sensitive information

Suggested Schedules

1. List of Specific Records: Detailed inventory of documents and information covered by the authorization

2. Identity Verification Documents: Copies of identification documents of authorizing party

3. Additional Consent Forms: Any supplementary authorization forms required by specific institutions

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

Relevant legal definitions

Clauses

Relevant Industries

Healthcare
Financial Services
Education
Employment
Insurance

Relevant Teams

Legal
Human Resources
Compliance
Information Security
Records Management

Relevant Roles

Privacy Officer
Compliance Manager
HR Manager
Medical Records Administrator
Data Protection Officer

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Let's create your Authorization For Disclosure Of Information Form

Authors

Alex Denne

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