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1. Parties: Identification of the data subject (person giving consent) and the organization requesting consent, including full names, identification numbers, and contact details
2. Background: Brief context explaining why the information release is needed and the relationship between the parties
3. Definitions: Clear definitions of key terms used in the form, including 'Personal Data', 'Sensitive Personal Data', 'Processing', and other relevant terms as defined in the PDPA
4. Information to be Released: Specific description of the personal data/information to be disclosed, categorized clearly and precisely
5. Purpose of Disclosure: Clear statement of the specific purpose(s) for which the information will be used
6. Recipients of Information: Identification of who will receive the information, including any third parties
7. Duration of Consent: Specification of how long the consent remains valid
8. Rights of the Data Subject: Statement of the data subject's rights under PDPA, including right to withdraw consent
9. Declaration and Signature: Formal declaration of consent and space for signature, date, and witness details
1. Special Category Data Consent: Additional explicit consent section for sensitive personal data such as health information, religious beliefs, or biometric data
2. International Transfer Consent: Required when personal data may be transferred outside Malaysia
3. Emergency Contact Authorization: Optional section for authorizing release of information to emergency contacts
4. Specific Legal Requirements: Additional sections required for specific sectors (e.g., financial services, healthcare)
5. Third Party Authorization: When consent is given by a legally authorized representative rather than the data subject
6. Withdrawal Procedure: Detailed procedure for withdrawing consent, if more detailed explanation is needed
1. Schedule A - Details of Personal Information: Detailed list of specific personal information to be released, categorized by type
2. Schedule B - Authorized Recipients: Complete list of all authorized recipients of the information, including contact details
3. Schedule C - Processing Activities: Detailed description of how the information will be processed, stored, and handled
4. Appendix 1 - Privacy Notice: Copy of the organization's privacy notice or relevant excerpts
5. Appendix 2 - Withdrawal Form: Template form for withdrawing consent in the future
Sensitive Personal Data
Data Subject
Data Controller
Data Processor
Consent
Processing
Disclosure
Third Party
Authorized Recipient
Identity Card
Personal Information
Confidential Information
Release Authorization
Privacy Notice
Data Protection Officer
Transfer
Record
Information System
Commercial Transaction
Data Protection Principles
Cross Border Transfer
Processing Purpose
Withdrawal Notice
Authorization Period
Information Scope
Purpose Limitation
Data Processing
Confidentiality
Data Protection
Third Party Disclosure
Duration
Rights Reserved
Withdrawal Rights
Cross-Border Transfer
Security Measures
Privacy Notice
Liability
Representation
Authorization
Indemnification
Governing Law
Dispute Resolution
Severability
Healthcare
Banking and Financial Services
Insurance
Education
Human Resources
Telecommunications
Government Services
Professional Services
Real Estate
Retail
Technology
Travel and Hospitality
Legal
Compliance
Human Resources
Information Technology
Data Protection
Risk Management
Operations
Customer Service
Administrative Services
Information Security
Records Management
Data Protection Officer
Compliance Manager
Legal Counsel
Privacy Officer
Human Resources Manager
Information Security Officer
Risk Manager
Operations Manager
Customer Service Manager
Administrative Officer
Healthcare Administrator
Financial Services Manager
Records Manager
Corporate Secretary
IT Security Manager
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