Confidentiality Release Form Template for Belgium

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Key Requirements PROMPT example:

Confidentiality Release Form

"I need a Confidentiality Release Form under Belgian law to allow our medical research institute to share anonymized patient data with a pharmaceutical company for a clinical trial starting in March 2025."

Document background

The Confidentiality Release Form is essential in situations where there is a need to formally authorize the disclosure of confidential information that would otherwise be protected under confidentiality obligations or agreements. This document is particularly relevant in the Belgian legal context, where it must comply with both national civil law and EU data protection requirements. The form is commonly used in professional settings, research collaborations, medical information releases, and business transactions where protected information needs to be shared with specific parties for defined purposes. It should clearly identify the information being released, the parties involved, and the scope of permitted use. The document provides legal protection for both the releasing and receiving parties by formally documenting the authorization for disclosure.

Suggested Sections

1. Identification of Parties: Details of the party releasing confidential information (Releasor) and the party receiving the release (Releasee), including full legal names, addresses, and any relevant registration numbers

2. Background: Brief context explaining the relationship between parties and why the confidentiality release is necessary

3. Definitions: Clear definitions of key terms, particularly 'Confidential Information' and the scope of information being released

4. Scope of Release: Specific description of what confidential information is being released and for what purposes

5. Consent and Authorization: Express statement of consent to release the specified confidential information, including any GDPR-required consent language

6. Duration: Time period for which the release is valid

7. Acknowledgment: Statement that the Releasor understands the implications of releasing the confidential information

8. Execution: Signature block with date and formal execution requirements

Optional Sections

1. Third Party Rights: Include when the confidential information might affect or belong to third parties not directly party to the release

2. Specific Usage Terms: Include when there are specific limitations or conditions on how the released information can be used

3. Data Protection Provisions: Include detailed GDPR compliance sections when the confidential information includes personal data

4. Indemnification: Include when the Releasee needs to indemnify the Releasor against potential claims arising from the information release

5. Governing Law and Jurisdiction: Include when there might be cross-border implications or specific jurisdictional requirements

Suggested Schedules

1. Schedule 1 - Description of Confidential Information: Detailed list or description of all confidential information being released

2. Schedule 2 - Authorized Recipients: List of specific individuals or entities authorized to receive and use the confidential information (if applicable)

3. Schedule 3 - Specific Usage Conditions: Detailed conditions and limitations on how the released information can be used (if applicable)

4. Appendix A - Consent Forms: Any additional consent forms required under GDPR or Belgian law, particularly for personal data

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 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

Identification of Parties
Recitals
Definitions
Scope of Release
Consent and Authorization
Data Protection
Duration
Purpose of Release
Permitted Use
Third Party Rights
Warranties and Representations
Acknowledgments
Further Assurance
Severability
Governing Law
Jurisdiction
Entire Agreement
Execution

Relevant Industries

Healthcare

Financial Services

Technology

Professional Services

Research & Development

Education

Manufacturing

Pharmaceuticals

Consulting

Legal Services

Human Resources

Information Technology

Relevant Teams

Legal

Compliance

Human Resources

Information Security

Privacy

Risk Management

Research & Development

Corporate Secretariat

Executive Leadership

Information Technology

Data Protection

Relevant Roles

Legal Counsel

Data Protection Officer

Compliance Manager

Human Resources Director

Research Director

Medical Director

Information Security Officer

Privacy Officer

Corporate Secretary

Risk Manager

Project Manager

Department Head

Chief Executive Officer

Chief Financial Officer

Chief Legal Officer

Find the exact document you need

Authorization To Share Medical Information Form

A Belgian-compliant authorization form for sharing medical information, meeting GDPR and local healthcare law requirements.

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Let's create your Confidentiality Release Form

Authors

Alex Denne

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