Privacy Release Form Template for Philippines

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Key Requirements PROMPT example:

Privacy Release Form

"I need a Privacy Release Form for my medical clinic in Manila, compliant with Philippine healthcare regulations, to collect and process patient health records starting January 2025, with specific provisions for sharing data with affiliated hospitals and insurance providers."

Document background

The Privacy Release Form is a crucial document used in the Philippines when organizations need to obtain explicit consent for collecting, processing, and sharing personal information. This document is designed to comply with the requirements of the Data Privacy Act of 2012 (RA 10173) and related regulations enforced by the National Privacy Commission. It becomes necessary when organizations collect personal data beyond what is permitted by law without explicit consent, or when additional authorization is needed for specific data processing activities. The form typically includes comprehensive details about the types of information being collected, intended uses, sharing permissions, and the data subject's rights. Organizations should implement this Privacy Release Form as part of their data protection compliance program, particularly when handling sensitive personal information or when data processing goes beyond routine operational needs.

Suggested Sections

1. Parties: Identification of the data subject (individual giving consent) and the organization/entity receiving the authorization

2. Background: Context explaining the purpose and circumstances requiring the privacy release

3. Definitions: Clear definitions of key terms used in the form, including 'personal data', 'processing', 'consent', and other relevant terms as defined in the Data Privacy Act

4. Scope of Personal Information: Detailed listing of the specific types of personal information covered by the release

5. Purpose of Collection and Processing: Clear statement of how the personal information will be used, processed, and shared

6. Consent Declaration: Express declaration of consent for the collection, processing, and sharing of personal information

7. Duration of Consent: Specification of how long the consent remains valid

8. Rights of the Data Subject: Statement of the rights retained by the data subject under the Data Privacy Act

9. Execution: Signature block and date of execution

Optional Sections

1. Third Party Disclosure: Required when personal information may be shared with third parties, listing potential recipients and purposes

2. International Data Transfers: Required when personal information may be transferred outside the Philippines

3. Revocation Process: Detailed process for withdrawing consent, recommended for longer-term or complex data processing arrangements

4. Security Measures: Description of security measures for protecting personal information, recommended for sensitive data collection

5. Liability and Indemnification: Added when there's a need to address potential liability issues and compensation

6. Emergency Contact Authorization: Required when the release includes permission to contact designated emergency contacts

Suggested Schedules

1. Schedule A - Types of Personal Information: Detailed categorization of personal information being collected and processed

2. Schedule B - Authorized Recipients: List of specific entities or persons authorized to receive the personal information

3. Schedule C - Processing Activities: Detailed description of specific processing activities authorized by the consent

4. Appendix 1 - Data Subject Rights: Comprehensive explanation of data subject rights under Philippine law

5. Appendix 2 - Security Protocols: Technical and organizational measures for protecting personal information

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Education

Financial Services

Insurance

Real Estate

Technology

Retail

Human Resources

Professional Services

Media and Entertainment

Telecommunications

Travel and Hospitality

Government Services

Non-Profit Organizations

Research Institutions

Relevant Teams

Legal

Compliance

Human Resources

Information Technology

Information Security

Risk Management

Operations

Customer Service

Data Privacy

Records Management

Corporate Governance

Internal Audit

Relevant Roles

Data Protection Officer

Privacy Officer

Compliance Manager

Legal Counsel

Human Resources Manager

Information Security Officer

Risk Management Officer

Operations Manager

Customer Service Manager

Project Manager

IT Director

Chief Privacy Officer

Chief Compliance Officer

Chief Legal Officer

Records Manager

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Let's create your Privacy Release Form

Authors

Alex Denne

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