Consent Information Form Template for Belgium

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Key Requirements PROMPT example:

Consent Information Form

"I need a Consent Information Form for my medical research study starting in March 2025, which will collect sensitive health data from adult participants in Brussels, with specific provisions for data sharing with other EU research institutions."

Document background

The Consent Information Form is a crucial document required under Belgian law and GDPR for organizations processing personal data where consent is the legal basis for processing. This document must be used whenever an organization needs to obtain explicit, informed consent from individuals before collecting and processing their personal data. The form ensures compliance with Article 7 of GDPR and the Belgian Data Protection Act of 2018, providing transparent information about data processing activities and enabling data subjects to make informed decisions about their personal data. It must be presented in clear, plain language and, depending on the region in Belgium, may need to be available in multiple official languages (Dutch, French, or German). The document is particularly important in contexts where special categories of personal data are processed or when dealing with vulnerable data subjects such as minors.

Suggested Sections

1. Data Controller Information: Clear identification of the organization/entity collecting consent, including contact details and Data Protection Officer information if applicable

2. Purpose of Data Processing: Specific, explicit description of why the personal data is being collected and how it will be used

3. Data Categories: Detailed list of personal data categories that will be collected and processed

4. Processing Activities: Description of how the data will be processed, stored, and protected

5. Data Subject Rights: Clear explanation of individual rights under GDPR including right to withdraw consent, access data, request deletion, etc.

6. Duration of Processing: Information about how long the data will be stored and processed

7. Declaration of Consent: Clear statement of consent with signature/acknowledgment section

Optional Sections

1. International Transfers: Required if personal data will be transferred outside the EU/EEA, detailing the safeguards in place

2. Automated Decision Making: Required if automated decision-making or profiling will be performed using the personal data

3. Third Party Recipients: Required if data will be shared with third parties, listing categories of recipients

4. Special Categories of Data: Required if processing sensitive personal data (health, religious beliefs, etc.), detailing specific safeguards

5. Children's Data Processing: Required if collecting data from minors, including parental consent requirements

6. Language Choice: Required in bilingual regions of Belgium, allowing choice between official languages

Suggested Schedules

1. Privacy Policy: Detailed privacy policy providing additional information about data processing practices

2. Data Processing Activities: Detailed list of specific processing activities and their purposes

3. Security Measures: Description of technical and organizational measures to protect personal data

4. Third Party List: Detailed list of third parties who may receive the data, if applicable

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

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Authors

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