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1. Affiant Information: Identity and qualifications of the person making the affidavit, including full legal name, position, professional credentials, and relationship to the medical records
2. Legal Authority: Statement establishing the affiant's legal authority to make declarations about the medical records
3. Record Identification: Detailed description of the medical records being authenticated, including patient name, medical record numbers, date ranges, and facility information
4. Custody Declaration: Statement regarding the chain of custody and proper maintenance of the records
5. Authentication Statement: Formal declaration that the records are genuine, complete, and maintained in the ordinary course of business
6. Compliance Declaration: Statement confirming compliance with UAE healthcare laws and regulations regarding record-keeping
7. Verification: Formal statement verifying that all declarations are true and correct to the best of the affiant's knowledge
8. Attestation: Official attestation clause and space for notarization or legal authentication as required by UAE law
1. Electronic Records Statement: Additional declarations specific to electronic medical records, used when the records in question are maintained electronically
2. Translation Certification: Statement regarding the translation of records if originally in a language other than Arabic or English
3. Third-Party Records Declaration: Additional section when including records from other healthcare providers or facilities
4. Privacy Compliance: Specific statements regarding compliance with UAE privacy laws, used when sensitive or specially protected information is included
5. Cross-Border Transfer: Additional declarations required when records may be used outside the UAE
1. Schedule A - Record Index: Detailed index of all medical records covered by the affidavit, including dates, types of records, and page numbers
2. Schedule B - Custodian Credentials: Copies of relevant professional licenses and credentials of the affiant
3. Schedule C - Facility Certifications: Copies of relevant facility licenses and certifications
4. Appendix 1 - Record Summaries: Summary sheets of the medical records being authenticated, if applicable
5. Appendix 2 - Chain of Custody Documentation: Documentation showing the chain of custody for the medical records, if relevant
Medical Records
Electronic Health Records
Healthcare Facility
Custodian of Records
Patient
Medical Record Number
Healthcare Provider
Chain of Custody
Authentication
Certification
Notarization
Original Records
Certified Copy
Record Maintenance
Health Information System
Medical Documentation
Treatment Period
Authorized Representative
Healthcare Authority
Professional License
Facility License
Medical Practice
Patient Identification
Record Repository
Data Protection
Confidential Information
Legal Proceeding
Ordinary Course of Business
Records Management System
Digital Signature
Electronic Authentication
Medical Institution
Healthcare Services
Official Translation
Authority and Capacity
Record Authentication
Custody Declaration
Confidentiality
Compliance
Record Maintenance
Data Protection
Verification
Certification
Electronic Records
Translation
Chain of Custody
Professional Qualification
Record Access
Privacy Protection
Legal Compliance
Documentation Standards
Record Integrity
Attestation
Healthcare
Legal Services
Insurance
Medical Administration
Healthcare Technology
Pharmaceutical
Clinical Research
Healthcare Consulting
Medical Education
Healthcare Compliance
Legal Affairs
Medical Records
Compliance
Risk Management
Quality Assurance
Healthcare Documentation
Clinical Administration
Patient Services
Medical Administration
Document Control
Medical Records Manager
Healthcare Facility Administrator
Compliance Officer
Legal Affairs Director
Medical Director
Health Information Manager
Quality Assurance Manager
Risk Management Officer
Healthcare Documentation Specialist
Medical Records Custodian
Clinical Affairs Manager
Healthcare Legal Counsel
Medical Services Coordinator
Patient Services Director
Documentation Control Manager
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