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Privacy Statement And Consent Form

Privacy Statement And Consent Form Template for Philippines

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Privacy Statement And Consent Form

"I need a Privacy Statement and Consent Form for my healthcare clinic in Manila that collects patient medical data and shares it with affiliated hospitals, including provisions for telemedicine services launching in January 2025."

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Document background
The Privacy Statement And Consent Form is a crucial document required under the Philippines Data Privacy Act of 2012 for organizations collecting and processing personal data. This document should be used whenever an organization collects personal information from individuals, whether they are customers, employees, students, patients, or other stakeholders. It serves as both an informative statement detailing how personal data will be handled and a legal record of consent from the data subject. The document must include specific elements required by Philippine law, such as the purposes of processing, data subject rights, security measures, and retention periods. Organizations should customize this template based on their specific data processing activities while ensuring compliance with the Data Privacy Act and relevant regulations from the National Privacy Commission.
Suggested Sections

1. Introduction: Overview of the document's purpose and the organization collecting the data

2. Scope: Defines who the privacy statement applies to and what activities it covers

3. Definitions: Key terms used in the document, aligned with definitions from the Data Privacy Act

4. Types of Personal Data Collected: Detailed list of personal and sensitive personal information being collected

5. Purposes of Collection and Processing: Specific purposes for which the personal data will be collected and processed

6. Legal Basis for Processing: Legal grounds under the Data Privacy Act for processing personal information

7. Data Subject Rights: Enumeration and explanation of all rights under the Data Privacy Act

8. Data Protection Measures: Security measures implemented to protect personal data

9. Data Retention Period: How long the data will be kept and criteria for determining retention periods

10. Data Sharing and Disclosure: Information about third parties who may receive the data and purposes for sharing

11. Consent Declaration: Explicit consent statement and signature section

12. Contact Information: Details of the Data Protection Officer and how to raise concerns or exercise rights

Optional Sections

1. International Data Transfers: Required if personal data will be transferred outside the Philippines

2. Automated Decision Making: Required if the organization uses automated processing to make decisions about individuals

3. Cookies and Tracking Technologies: Required for online services that use cookies or similar technologies

4. Special Categories of Data: Required when collecting sensitive personal information as defined in the Data Privacy Act

5. Children's Privacy: Required when services may involve collecting data from minors

6. Marketing Communications: Required if personal data will be used for marketing purposes

7. CCTV Monitoring: Required if premises are monitored by surveillance cameras

Suggested Schedules

1. Schedule A - Categories of Personal Data: Detailed breakdown of all personal data categories collected and processed

2. Schedule B - Third Party Recipients: List of third parties with whom data may be shared and their purposes

3. Schedule C - Technical and Organizational Measures: Detailed description of security measures implemented to protect personal data

4. Schedule D - Data Retention Schedule: Specific retention periods for different categories of personal data

5. Appendix 1 - Data Subject Request Form: Template form for data subjects to exercise their rights

6. Appendix 2 - Privacy Impact Assessment Summary: Summary of privacy impact assessment results if applicable

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

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Relevant legal definitions
Personal Data
Personal Information
Sensitive Personal Information
Processing
Data Subject
Data Controller
Data Processor
Data Protection Officer
Consent
Data Sharing
Data Access
Data Breach
Third Party
Technical and Organizational Measures
Privacy Impact Assessment
Information and Communications System
Data Collection
Data Storage
Data Disposal
Automated Processing
Profiling
Cross-border Transfer
Data Retention
Anonymization
Pseudonymization
Privacy Statement
Consent Form
Legitimate Interest
Data Subject Rights
Security Measures
Authorized Personnel
Disclosure
Direct Marketing
Privacy Notice
Data Protection Laws
Relevant Industries

Healthcare

Financial Services

Education

Retail

Technology

Telecommunications

Insurance

Human Resources

E-commerce

Professional Services

Real Estate

Manufacturing

Hospitality

Transportation

Government Services

Relevant Teams

Legal

Compliance

Information Technology

Information Security

Human Resources

Risk Management

Data Protection

Privacy

Operations

Customer Service

Marketing

Internal Audit

Relevant Roles

Data Protection Officer

Privacy Officer

Compliance Manager

Legal Counsel

Information Security Officer

Risk Manager

HR Director

IT Manager

Operations Manager

Customer Service Manager

Marketing Director

Chief Information Officer

Chief Privacy Officer

Chief Compliance Officer

General Counsel

Industries
Data Privacy Act of 2012 (Republic Act No. 10173): The primary legislation governing personal data protection in the Philippines, establishing requirements for processing personal information, rights of data subjects, and obligations of personal information controllers and processors.
Implementing Rules and Regulations of the Data Privacy Act of 2012: Detailed regulations that implement the Data Privacy Act, providing specific guidelines on compliance, security measures, data subject rights, and breach notification procedures.
NPC Circular No. 16-01: Guidelines for data protection officers, providing requirements for the appointment and responsibilities of DPOs in organizations.
Philippine Constitution Article III, Section 3: Constitutional provision on the right to privacy of communication and correspondence, which forms the fundamental basis for privacy rights in the Philippines.
Civil Code of the Philippines (Republic Act No. 386): Relevant provisions regarding consent, contracts, and obligations that affect the validity and enforceability of the privacy statement and consent form.
NPC Circular No. 2020-03: Guidelines on personal data breach management, including notification and reporting requirements in case of data breaches.
NPC Advisory No. 2017-01: Guidelines on data sharing agreements, relevant when personal information may be shared with third parties.
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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