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1. Parties: Identification of the patient (data subject), the healthcare provider releasing the information, and the recipient(s) of the medical information
2. Background: Brief context explaining the need for the medical information release
3. Definitions: Key terms used in the document, including types of medical information, processing activities, and relevant parties
4. Scope of Information: Detailed description of the medical information to be released, including time periods covered
5. Purpose of Release: Clear statement of the specific purpose(s) for which the medical information will be used
6. Duration of Consent: Time period for which the consent remains valid, including expiration date if applicable
7. Rights of the Patient: Statement of the patient's rights under Swiss law, including right to withdraw consent and access data
8. Data Protection Measures: Description of how the information will be protected during transfer and storage
9. Signatures: Space for dated signatures of all relevant parties, including patient and healthcare provider
1. International Transfer: Required when medical information will be transferred outside Switzerland, detailing compliance with cross-border data transfer requirements
2. Research Use: Required when information may be used for research purposes, including specific consents required under the Human Research Act
3. Electronic Processing: Required when information will be processed electronically, including compliance with EPRA requirements
4. Third Party Access: Required when additional parties beyond the primary recipient may need access to the information
5. Special Categories of Data: Required when releasing particularly sensitive information such as genetic data or psychiatric records
1. Schedule 1 - Specific Records: Detailed list of specific medical records, test results, or documents to be released
2. Schedule 2 - Authorized Recipients: List of specific individuals or entities authorized to receive the medical information
3. Schedule 3 - Processing Activities: Detailed description of how the medical information will be processed, stored, and protected
4. Appendix A - Patient Rights Information: Detailed explanation of patient rights under Swiss law regarding their medical information
Protected Health Information
Personal Data
Sensitive Personal Data
Data Subject
Data Controller
Data Processor
Healthcare Provider
Treating Physician
Medical Records
Health Data
Consent
Processing
Transfer
Disclosure
Confidential Information
Electronic Health Record
Medical Treatment
Healthcare Services
Authorization Period
Recipients
Third Party
Data Protection Officer
Professional Secrecy
Release Authorization
Patient Rights
Withdrawal of Consent
Cross-border Transfer
Purpose of Processing
Security Measures
Data Protection
Confidentiality
Information Access
Duration
Revocation Rights
Purpose Limitation
Data Security
Transfer Authorization
Privacy Rights
Information Scope
Third Party Disclosure
Patient Rights
Healthcare Provider Obligations
Record Maintenance
International Transfer
Liability
Professional Secrecy
Electronic Processing
Data Retention
Emergency Disclosure
Regulatory Compliance
Healthcare
Insurance
Medical Research
Pharmaceuticals
Biotechnology
Healthcare Technology
Medical Devices
Healthcare Administration
Public Health
Social Services
Legal
Compliance
Medical Records
Privacy and Data Protection
Patient Relations
Healthcare Administration
Quality Assurance
Clinical Operations
Information Management
Risk Management
Medical Records Administrator
Privacy Officer
Compliance Manager
Healthcare Administrator
Medical Director
Data Protection Officer
Clinical Research Coordinator
Insurance Claims Manager
Medical Secretary
Legal Counsel
Healthcare Privacy Specialist
Patient Relations Manager
Medical Information Officer
Quality Assurance Manager
Healthcare Operations Manager
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