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1. Date and Place: Current date and location of signing
2. Authorizing Party Details: Full name, address, and contact information of the person giving authorization
3. Recipient Organization Details: Name and address of the organization authorized to release the information
4. Information Scope: Specific description of what information is authorized for release
5. Authorized Recipients: Details of who is authorized to receive the information
6. Purpose Statement: Clear statement of the purpose for which the information may be used
7. Duration of Authorization: Specific timeframe for which the authorization is valid
8. Data Protection Statement: Reference to GDPR and data protection rights
9. Signature Block: Space for signature, printed name, and date
1. Witness Details: Used when additional verification of the authorization is required, includes witness name and signature
2. Revocation Clause: Statement explaining how and when the authorization can be revoked, recommended for longer-term authorizations
3. Special Instructions: Any specific handling instructions or restrictions on the information release
4. Emergency Contact: Alternative contact person in case of queries, particularly useful for medical information releases
5. Confidentiality Statement: Additional privacy and confidentiality requirements for sensitive information
1. List of Specific Records: Detailed itemization of specific documents or records to be released, if applicable
2. Identification Verification: Copies of ID documents used to verify the identity of the authorizing party
3. Prior Authorizations: List of any previous authorizations being superseded by this letter, if applicable
Sensitive Personal Data
Data Subject
Authorized Recipients
Information Holder
Authorization Period
Consent
Data Controller
Data Processor
Confidential Information
Release
Processing
Third Party
Purpose
Revocation
Records
Authorized Representatives
Written Notice
Valid Identification
Data Protection Laws
Scope of Information
Data Protection
Consent
Duration
Purpose Limitation
Confidentiality
Information Access
Third Party Disclosure
Revocation Rights
Privacy Protection
Identity Verification
Record Keeping
Liability
Governing Law
Emergency Provisions
Data Security
Contact Details
Authentication
Healthcare
Banking and Financial Services
Education
Legal Services
Insurance
Human Resources
Government and Public Services
Social Services
Real Estate
Professional Services
Telecommunications
Employment Services
Legal
Compliance
Human Resources
Data Protection
Information Security
Risk Management
Operations
Administration
Records Management
Customer Service
Data Protection Officer
Compliance Manager
HR Manager
Legal Counsel
Privacy Officer
Records Manager
Information Security Officer
Company Secretary
Risk Manager
Operations Manager
Healthcare Administrator
Educational Administrator
Bank Manager
Insurance Claims Manager
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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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