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1. Parties: Identifies all parties involved: the person/organization requesting consent, the person giving consent, and the third party to whom the consent relates
2. Background: Explains the context and purpose for which the third party consent is being sought
3. Definitions: Defines key terms used throughout the consent form
4. Scope of Consent: Clearly outlines what specific activities, access, or permissions are being authorized
5. Duration of Consent: Specifies how long the consent remains valid and when it expires
6. Privacy Statement: Explains how personal information will be collected, used, and protected in accordance with PIPEDA and applicable privacy laws
7. Withdrawal of Consent: Explains the process and right to withdraw consent
8. Declaration and Signature: Formal statement of understanding and agreement, with space for signatures and dates
1. Electronic Communication Consent: Required when consent form will be handled electronically, addressing requirements under the Electronic Commerce Act
2. Emergency Contact Authorization: Used when consent involves emergency situations or medical contexts
3. Minor Consent Provisions: Required when the consent involves a minor or someone under guardianship
4. Information Sharing Limitations: Additional restrictions or conditions on how information can be shared or used
5. Jurisdiction Specific Provisions: Required when consent form needs to address specific provincial privacy law requirements
1. Schedule A - Detailed Description of Authorized Activities: Comprehensive list of specific activities or access being authorized
2. Schedule B - Privacy Policy: Detailed privacy policy and information handling procedures
3. Schedule C - Authorized Third Parties: List of specific individuals or organizations authorized to act under the consent
4. Appendix 1 - Identification Documents: Copies or details of identification documents used to verify the identity of parties
5. Appendix 2 - Supporting Documentation: Any additional documents referenced in the consent form or required for context
Personal Information
Confidential Information
Third Party
Authorized Representative
Consent Grantor
Requesting Organization
Effective Date
Consent Period
Privacy Laws
PIPEDA
Processing
Data Subject
Withdrawal Notice
Authorized Purpose
Sensitive Information
Information Handling
Electronic Consent
Digital Signature
Force Majeure
Jurisdiction
Notice
Business Day
Records
Consent Grant
Information Use
Duration
Confidentiality
Data Protection
Rights and Obligations
Withdrawal Rights
Information Access
Disclosure Limitations
Security Measures
Liability
Representations and Warranties
Emergency Provisions
Electronic Communications
Notice
Governing Law
Severability
Entire Agreement
Amendment
Assignment
Healthcare
Financial Services
Education
Real Estate
Insurance
Legal Services
Social Services
Telecommunications
Professional Services
Research and Development
Human Resources
Childcare Services
Legal
Compliance
Privacy
Human Resources
Information Security
Risk Management
Operations
Client Services
Administrative Services
Records Management
Privacy Officer
Compliance Manager
Legal Counsel
Human Resources Manager
Medical Records Administrator
Information Security Officer
Risk Manager
Data Protection Officer
Operations Manager
Client Services Manager
Administrative Coordinator
Records Management Specialist
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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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