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Consent To Disclose Form
I need a Consent to Disclose Form for our medical research institute in Denmark to obtain patient consent for sharing anonymized health data with pharmaceutical companies for a clinical trial starting in March 2025, including provisions for international data transfers.
1. Parties: Identification of the data subject (person giving consent) and the data controller (organization requesting consent), including full names, contact details, and any relevant identification numbers
2. Purpose of Disclosure: Clear and specific explanation of why the information is being disclosed and how it will be used
3. Information to be Disclosed: Detailed list of the specific personal data that will be shared, categorized by type
4. Recipients of Information: Identification of all parties who will receive the disclosed information, including any third parties
5. Duration of Consent: Specification of how long the consent will remain valid, including any expiry date if applicable
6. Rights of the Data Subject: Clear explanation of the data subject's rights under GDPR, including right to withdraw consent and right to data portability
7. Declaration and Signature: Formal declaration of consent and space for signature, date, and any witness requirements
1. Special Categories of Data: Additional section required when sensitive personal data (as defined in GDPR Article 9) is being disclosed, requiring explicit consent
2. International Transfers: Required when data will be transferred outside the EU/EEA, explaining the safeguards in place
3. Processing Activities: Detailed description of specific processing activities when consent covers multiple or complex processing operations
4. Parent/Guardian Consent: Required when the data subject is under 13 years old (Danish age of digital consent) or lacks capacity to consent
1. Detailed Data Categories: Comprehensive list of all specific data fields and categories to be disclosed, particularly useful for complex data sets
2. Third Party Recipients List: Complete list of all third parties who will receive the data, including their contact details and purposes for receiving the data
3. Privacy Notice: Full privacy notice or link to it, providing detailed information about how the data will be processed
Authors
Sensitive Personal Data
Data Subject
Data Controller
Data Processor
Third Party
Consent
Processing
Disclosure
Transfer
Recipients
Withdrawal of Consent
Data Protection Officer
Supervisory Authority
Danish Data Protection Agency
Purpose of Processing
Data Protection Legislation
GDPR
Danish Data Protection Act
Personal Data Categories
International Transfer
Authorized Recipients
Data Subject Rights
Privacy Notice
Processing Activities
Legal Basis
Data Protection Impact Assessment
Special Categories of Personal Data
Valid Consent
Explicit Consent
Data Processing Purpose
Scope of Disclosure
Duration and Expiry
Rights and Obligations
Data Subject Rights
Withdrawal of Consent
Third Party Disclosure
International Transfer
Data Security
Confidentiality
Privacy Notice Reference
Contact Details
Governing Law
Signature and Authorization
Processing Activities
Special Categories of Data
Data Protection Safeguards
Complaint Procedures
Record Keeping
Healthcare
Financial Services
Education
Insurance
Human Resources
Professional Services
Public Sector
Technology
Telecommunications
Research and Development
Pharmaceutical
Social Services
Legal
Compliance
Privacy
Human Resources
Information Security
Risk Management
Operations
Client Services
Records Management
Data Protection
Administrative Services
Data Protection Officer
Privacy Manager
Compliance Officer
Legal Counsel
HR Manager
Information Security Manager
Risk Manager
Records Manager
Healthcare Administrator
Financial Services Administrator
Education Administrator
Client Relations Manager
Operations Manager
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