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1. Information Provider Details: Full name, contact information, and any relevant identification details of the person/entity authorizing the release of information
2. Third Party Recipient Details: Full name, contact information, and role/relationship of the party being authorized to receive the information
3. Information to be Released: Specific description of the information authorized for release, including categories, time periods, and any limitations
4. Purpose of Release: Clear statement of why the information is being released and how it will be used
5. Duration of Authorization: Specific timeframe for which the authorization is valid, including start and end dates
6. Privacy Notice: Statement about privacy rights and obligations under the Privacy Act 1988 and relevant legislation
7. Declaration and Signature: Formal declaration of consent and space for signature, date, and witness information if required
1. Revocation Rights: Section explaining how and when the authorization can be revoked, used when the authorization needs to be revocable
2. Special Conditions: Any specific conditions or restrictions on the use of information, included when there are particular limitations needed
3. Emergency Contacts: Alternative contact details in case of emergency, used particularly in medical or critical information releases
4. Information Handling Requirements: Specific requirements for how the information should be handled, stored, or destroyed, used when dealing with sensitive data
5. Multiple Party Authorization: Additional authorization sections when multiple parties need to provide consent, such as in cases involving joint accounts or guardianship
1. Schedule A - Details of Information: Detailed listing of specific information items, documents, or records to be released
2. Schedule B - Authorized Recipients List: List of specific individuals within the third party organization who are authorized to receive the information, if applicable
3. Appendix 1 - Identity Verification Requirements: Documentation requirements and procedures for verifying the identity of parties accessing the information
Confidential Information
Authorization Period
Information Provider
Third Party Recipient
Authorized Purpose
Authorized Representatives
Consent
Disclosure
Privacy Laws
Information Custodian
Sensitive Information
Release
Revocation Notice
Privacy Notice
Security Safeguards
Data Breach
Identity Verification
Information Handling Requirements
Witness
Consent and Declaration
Information Description
Purpose of Release
Duration and Expiry
Privacy Notice
Confidentiality
Data Protection
Third Party Obligations
Revocation Rights
Liability and Indemnity
Security Requirements
Access and Use Restrictions
Identity Verification
Record Keeping
Dispute Resolution
Governing Law
Severability
Healthcare
Financial Services
Education
Legal Services
Insurance
Real Estate
Government Services
Social Services
Telecommunications
Employment Services
Legal
Compliance
Human Resources
Information Security
Risk Management
Records Management
Customer Service
Operations
Administration
Data Protection
Privacy Officer
Compliance Manager
Legal Counsel
HR Manager
Medical Records Officer
Information Security Officer
Data Protection Officer
Risk Manager
Administrative Coordinator
Customer Service Manager
Operations Manager
Records Manager
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Genie’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; Genie’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it


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