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1. Client Details: Section for collecting the identifying information of the client including full name, contact details, and any relevant identification numbers
2. Information Owner/Controller Details: Details of the organization or entity that currently holds/controls the information
3. Information Recipient Details: Details of the person(s) or organization(s) to whom the information will be released
4. Information to be Released: Specific description of the information to be released, including type, date range, and format of information
5. Purpose of Release: Clear statement of the purpose(s) for which the information will be used
6. Duration of Authorization: Timeframe for which the authorization remains valid, including start and end dates
7. Privacy Notice: Statement explaining how the information will be handled, stored, and protected in accordance with privacy laws
8. Declaration and Consent: Client's acknowledgment and explicit consent to the release of information
9. Execution: Signature block for client, witnesses (if required), and date of signing
1. Special Conditions: Additional conditions or restrictions on the use of information, used when specific limitations need to be imposed
2. Health Information Specifics: Additional section required when dealing with health-related information, including specific consents required under health privacy laws
3. Third Party Authorization: Section to be included when the person signing is not the subject of the information (e.g., legal guardian, power of attorney)
4. Revocation Rights: Detailed explanation of how to revoke the authorization, included when the release period is longer term
5. International Transfer Notice: Required when information may be transferred outside Australia, detailing compliance with APP 8 regarding cross-border disclosure
1. Schedule A - Detailed Information List: Itemized list of specific documents or information to be released when the list is too extensive for the main form
2. Schedule B - Authorized Recipients: Detailed list of all authorized recipients when there are multiple parties who may receive the information
3. Appendix 1 - Privacy Collection Notice: Detailed privacy notice explaining how personal information will be collected, used, disclosed and protected as required by the Privacy Act
4. Appendix 2 - Proof of Identity Requirements: List of acceptable identification documents and requirements for verification of identity
Sensitive Information
Health Information
Authorized Representative
Client
Consent
Data Controller
Information Recipient
Release Period
Third Party
Privacy Laws
Australian Privacy Principles
Data Breach
Confidential Information
Collection Notice
Disclosure
Identifiers
Permitted Purpose
Records
Revocation Notice
Privacy Notice
Information Collection
Information Use
Information Disclosure
Data Security
Cross-border Transfer
Access Rights
Duration and Expiry
Revocation Rights
Confidentiality
Third Party Recipients
Purpose Limitation
Storage and Handling
Identity Verification
Records Management
Data Breach Notification
Liability and Indemnity
Governing Law
Execution
Healthcare
Financial Services
Education
Legal Services
Insurance
Real Estate
Professional Services
Government Services
Social Services
Telecommunications
Human Resources
Retail Banking
Aged Care
Childcare
Legal
Compliance
Privacy
Information Security
Records Management
Human Resources
Client Services
Risk Management
Operations
Information Management
Customer Relations
Data Protection
Privacy Officer
Compliance Manager
Legal Counsel
Data Protection Officer
Information Security Manager
Records Manager
Healthcare Administrator
Human Resources Manager
Client Services Manager
Risk Manager
Operations Manager
Practice Manager
Information Management Officer
Customer Relations 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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