Doctor Release Form Template for Denmark

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Doctor Release Form

I need a Doctor Release Form in Danish and English that authorizes the transfer of my complete medical history to a new healthcare provider in Copenhagen, with specific provisions for handling sensitive mental health records and ongoing treatment plans starting March 2025.

What is a Doctor Release Form?

The Doctor Release Form is a crucial document in the Danish healthcare system that facilitates the authorized sharing of patient medical information. It is required whenever patient medical records need to be transferred between healthcare providers or released to third parties such as insurance companies, employers, or other authorized recipients. The form ensures compliance with the Danish Health Act, Danish Authorization Act for Healthcare Professionals, and GDPR requirements. It includes comprehensive details about the scope of information being released, patient consent provisions, data protection measures, and the rights and responsibilities of all parties involved. This document is essential for maintaining patient privacy while enabling necessary information sharing in various situations such as continuing care, insurance claims, legal proceedings, or employment requirements.

What sections should be included in a Doctor Release Form?

1. Patient Information: Patient's full name, CPR number (Danish personal ID), contact details, and relevant medical record numbers

2. Healthcare Provider Information: Name, medical license number, and contact information of the healthcare provider/facility releasing the information

3. Scope of Release: Specific description of what medical information is being released, including time period covered

4. Purpose of Release: Clear statement of why the medical information is being released and who will receive it

5. Data Protection Notice: GDPR-compliant explanation of how the released information will be processed and protected

6. Patient Rights Statement: Information about the patient's rights under Danish law, including right to withdraw consent

7. Duration of Authorization: Timeframe for which the release authorization is valid

8. Signatures and Date: Space for patient signature, date, and witness signature if required

What sections are optional to include in a Doctor Release Form?

1. Legal Representative Authorization: Required when someone other than the patient is authorizing the release (e.g., guardian, power of attorney)

2. Specific Exclusions: Section listing any specific medical information that should NOT be released

3. Emergency Contact Information: Optional section for emergency contact details when relevant to the release purpose

4. Fee Information: Details about any applicable fees for records release, if relevant under Danish healthcare regulations

5. Translation Declaration: Required when the form is provided in multiple languages, confirming the Danish version prevails

What schedules should be included in a Doctor Release Form?

1. Schedule A - Detailed Medical Records List: Itemized list of specific medical records being released (e.g., test results, surgical records, prescriptions)

2. Schedule B - Third Party Recipients: List of authorized recipients of the medical information, including their contact details and purpose

3. Appendix 1 - Patient Rights Guide: Detailed information about patient rights under Danish healthcare law regarding medical records

4. Appendix 2 - Data Processing Information: Detailed GDPR-compliant information about how personal health data will be processed and protected

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

Relevant Industries

Healthcare

Insurance

Legal Services

Occupational Health

Social Services

Education

Sports and Athletics

Clinical Research

Pharmaceutical

Relevant Teams

Legal

Compliance

Medical Records

Patient Services

Data Protection

Quality Assurance

Administrative Services

Risk Management

Clinical Operations

Information Governance

Relevant Roles

Medical Doctor

Healthcare Administrator

Legal Compliance Officer

Data Protection Officer

Medical Records Manager

Healthcare Facility Director

Insurance Claims Processor

Occupational Health Officer

Clinical Research Coordinator

Healthcare Legal Counsel

Privacy Officer

Medical Secretary

Patient Services Coordinator

Healthcare Quality Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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