The Medical Records Release Authorisation Form is essential for managing access to confidential medical information in England and Wales. It is used when patients or their representatives need to transfer medical records between healthcare providers, share information with insurance companies, or provide access to legal representatives. The form ensures compliance with data protection regulations and maintains patient confidentiality while facilitating necessary information sharing. It includes specific details about the records being requested, the purpose of the release, and the duration of the authorization.
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1. Patient Information: Full name, date of birth, NHS number, address, contact details
2. Healthcare Provider Details: Name and address of the healthcare provider holding the records
3. Scope of Authorization: Specific records being requested and date range
4. Recipient Information: Details of who is authorized to receive the records
5. Duration of Authorization: Time period for which the authorization is valid
6. Patient Declaration: Confirmation of understanding and consent
1. Third Party Authorization: Additional section required when someone other than the patient is requesting records (legal representative or next of kin)
2. Capacity Declaration: Section for assessment of patient's capacity to provide consent, required when there are concerns about patient's mental capacity
3. Specific Exclusions: Section for specifying any information to be excluded from release, used when patient wishes to withhold certain information
1. Schedule 1 - Proof of Identity: List of required identification documents and acceptable forms of ID
2. Schedule 2 - Proof of Authority: Documentation requirements for proving authority to act on patient's behalf
3. Schedule 3 - Fee Schedule: Details of any applicable costs associated with record retrieval and processing
Relevant legal definitions
Medical Records
Personal Data
Sensitive Personal Data
Healthcare Provider
Authorized Representative
Patient
Data Subject
Consent
Data Controller
Data Processor
Special Category Data
Confidential Information
Protected Health Information
Release Authorization
Third Party Recipient
Next of Kin
Legal Representative
Power of Attorney
Treatment Records
Medical History
Healthcare Professional
Mental Capacity
Valid Period
Authorization Period
Disclosure
Personal Data
Sensitive Personal Data
Healthcare Provider
Authorized Representative
Patient
Data Subject
Consent
Data Controller
Data Processor
Special Category Data
Confidential Information
Protected Health Information
Release Authorization
Third Party Recipient
Next of Kin
Legal Representative
Power of Attorney
Treatment Records
Medical History
Healthcare Professional
Mental Capacity
Valid Period
Authorization Period
Disclosure
Clauses
Patient Information
Authorization Scope
Consent
Disclosure Purpose
Duration and Expiry
Confidentiality
Data Protection
Rights of Access
Information Security
Third Party Access
Record Format
Delivery Method
Fees and Charges
Revocation Rights
Privacy Notice
Liability
Capacity Declaration
Emergency Disclosure
Information Accuracy
Record Retention
Governing Law
Complaint Procedure
Authorization Scope
Consent
Disclosure Purpose
Duration and Expiry
Confidentiality
Data Protection
Rights of Access
Information Security
Third Party Access
Record Format
Delivery Method
Fees and Charges
Revocation Rights
Privacy Notice
Liability
Capacity Declaration
Emergency Disclosure
Information Accuracy
Record Retention
Governing Law
Complaint Procedure
Relevant Industries
Relevant Teams
Relevant Roles
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