Consent Authorisation Form

Consent Authorisation Form Template for United States

Create a bespoke document in minutes, or upload and review your own.

4.6 / 5

4.8 / 5

Let's create your Consent Authorisation Form

1. Select your governing law and document type:

2. Enter your key requirements:

3. Create your document to edit, review or download

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

"I need a Consent Authorization Form for a medical research study starting March 2025, which will involve collecting and sharing patient data with three partner institutions in California, with specific provisions for handling sensitive health information and genetic data."

Document background

The Consent Authorization Form serves as a critical legal instrument in the United States, designed to document and formalize permissions granted by one party to another. This document type is essential in situations requiring explicit authorization for actions such as medical treatment, data sharing, research participation, or media usage. The form must comply with various federal regulations including HIPAA, COPPA, and state-specific consent laws, depending on its application. It typically includes comprehensive details about the scope of authorization, temporal limitations, and the rights of the consenting party. The Consent Authorization Form is particularly crucial in healthcare, research, educational, and corporate settings where formal documentation of permission is legally required or professionally prudent.

Suggested Sections

1. Title and Date: Clear identification of the document as a Consent Authorization Form and the effective date

2. Parties: Identification of the person/entity giving consent and the person/entity receiving authorization

3. Purpose of Authorization: Clear explanation of why the consent is being requested and how the authorization will be used

4. Information to be Disclosed: Specific details about what information is being authorized for disclosure or use

5. Duration of Authorization: The time period for which the consent remains valid, including start and end dates if applicable

6. Rights of the Consenting Party: Explanation of rights including the right to revoke consent and any limitations

7. Privacy Notice: Statement about how the information will be protected and used

8. Signature Block: Space for signatures, dates, and witness signatures if required

Optional Sections

1. Medical Information Specifics: Additional section when the consent involves protected health information under HIPAA

2. Digital Communications Consent: Section for authorizing electronic communications and notifications

3. Third Party Access: Section specifying any third parties who may receive or access the authorized information

4. International Data Transfer: Required when information may be transferred across international borders

5. Research Participation: Additional details when the consent is for research purposes

6. Media Release: Section for authorizing use of photos, videos, or other media

7. Financial Information: Section for authorization related to financial information disclosure

8. Minor Consent: Additional section when the consent involves a minor, including parental/guardian authorization

Suggested Schedules

1. Schedule A - Detailed Description of Information: Comprehensive list of specific information covered by the authorization

2. Schedule B - Authorized Recipients: List of specific individuals or entities authorized to receive the information

3. Schedule C - Privacy Policies: Detailed privacy policies and protection measures

4. Appendix 1 - Glossary: Definitions of technical or legal terms used in the document

5. Appendix 2 - Revocation Form: Template form for revoking the authorization

6. Appendix 3 - State-Specific Disclosures: Additional disclosures required by specific state laws

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

Education

Research & Development

Financial Services

Legal Services

Media & Entertainment

Technology

Non-Profit

Government

Insurance

Clinical Trials

Human Resources

Marketing

Relevant Teams

Legal

Compliance

Privacy

Human Resources

Risk Management

Information Security

Clinical Operations

Patient Services

Records Management

Research Administration

Data Protection

Corporate Governance

Operations

Relevant Roles

Compliance Officer

Legal Counsel

Privacy Officer

Medical Director

Research Coordinator

Human Resources Manager

Data Protection Officer

Clinical Trial Manager

Risk Manager

Operations Director

Healthcare Administrator

Information Security Officer

Patient Services Coordinator

Corporate Secretary

Records Manager

Find the exact document you need