The Consent To Share Medical Information With Family Member Letter is a crucial document in New Zealand's healthcare system that bridges the gap between patient privacy rights and family support in healthcare decisions. This document becomes necessary when patients wish to involve family members in their healthcare journey while maintaining control over their medical information. It complies with the Privacy Act 2020 and Health Information Privacy Code 2020, providing healthcare providers with clear authorization to share specified medical information with designated family members. The letter is particularly relevant in situations involving ongoing care, elderly patients, mental health support, or when patients need family assistance in managing their healthcare. It includes specific details about what information can be shared, with whom, and for how long, while protecting the patient's privacy rights under New Zealand law.
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1. Patient Information: Full legal name, date of birth, NHI number, and contact details of the patient
2. Authorized Family Member Details: Full name, relationship to patient, and contact information of the family member being authorized to receive medical information
3. Scope of Information Sharing: Specific details about what medical information can be shared (e.g., all medical records, specific condition information only, specific date ranges)
4. Duration of Authorization: Time period for which the consent is valid, including start date and end date if applicable
5. Healthcare Provider Information: Details of the healthcare provider(s) authorized to share the information
6. Patient Declaration: Statement of voluntary consent and understanding of the implications of sharing medical information
7. Signature Block: Space for patient signature, date, and witness signature if required
1. Interpreter Declaration: Required when the patient needs an interpreter to understand the consent
2. Mental Capacity Statement: Required when there are questions about the patient's capacity to provide informed consent
3. Emergency Contact Authorization: Additional section specifying if the authorized family member can act as emergency contact
4. Specific Exclusions: Section listing any specific medical information that should NOT be shared
5. Electronic Communication Consent: Additional authorization for sharing information via electronic means
1. Schedule A - Types of Medical Information: Detailed checklist of specific types of medical information authorized for sharing (e.g., test results, medications, treatment plans)
2. Schedule B - Authorized Healthcare Providers: Complete list of healthcare providers and facilities authorized to share information when multiple providers are involved
3. Schedule C - Privacy Statement: Detailed privacy notice explaining how the information will be handled and protected
Relevant legal definitions
Authorized Family Member
Health Information
Medical Records
Healthcare Provider
Personal Information
Sensitive Information
Treatment Information
Consent Period
Disclosure
NHI Number
Patient
Privacy Act
Health Information Privacy Code
Electronic Health Records
Confidential Information
Emergency Contact
Medical Practice
Treatment Provider
Clinical Notes
Test Results
Health Information
Medical Records
Healthcare Provider
Personal Information
Sensitive Information
Treatment Information
Consent Period
Disclosure
NHI Number
Patient
Privacy Act
Health Information Privacy Code
Electronic Health Records
Confidential Information
Emergency Contact
Medical Practice
Treatment Provider
Clinical Notes
Test Results
Clauses
Relevant Industries
Healthcare
Medical Services
Aged Care
Mental Health
Primary Care
Hospital Services
Allied Health Services
Disability Services
Community Health
Relevant Teams
Medical Records
Patient Services
Legal
Compliance
Clinical Administration
Front Desk
Privacy
Patient Care
Quality Assurance
Relevant Roles
Medical Doctor
General Practitioner
Practice Manager
Healthcare Administrator
Privacy Officer
Medical Records Manager
Nurse Manager
Clinical Director
Compliance Officer
Patient Services Coordinator
Legal Counsel
Healthcare Social Worker
Medical Secretary
Reception Manager
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