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1. Patient Information: Full legal name, date of birth, contact details, and any relevant patient ID numbers
2. Healthcare Provider Details: Name and details of the current healthcare provider/facility holding the medical information
3. Authorized Recipients: Names and details of individuals or organizations authorized to receive/discuss the medical information
4. Scope of Permission: Specific medical information that can be discussed/shared, including time period covered
5. Duration of Authorization: Specific timeframe for which the permission is valid
6. Patient Rights Statement: Statement explaining the patient's right to revoke permission and other relevant rights
7. Authentication: Patient signature, date, and any required witness signatures
1. Specific Exclusions: Used when certain medical information should be explicitly excluded from the permission
2. Emergency Contact: Include when an emergency contact person needs to be designated with specific permissions
3. Translation Declaration: Required when the letter is prepared in multiple languages or when translation services were used
4. Digital Communication Consent: Include when electronic sharing of information is anticipated
5. Mental Health Information: Special authorization section required when mental health information is involved, as per Mental Health Ordinance 2001
1. List of Specific Records: Detailed list of specific medical records covered by the permission, if applicable
2. Authorized Healthcare Providers List: List of specific healthcare providers authorized to share information, if multiple
3. Identity Verification Documents: Copies of identity documents used to verify the patient's identity
Healthcare Provider
Authorized Recipients
Protected Health Information
Medical Records
Authorization Period
Confidential Information
Disclosure
Patient Representative
Treatment
Healthcare Facility
Medical History
Personal Information
Electronic Health Records
Revocation
Consent
Medical Practitioner
Health Care Services
Sensitive Information
Emergency Contact
Healthcare
Medical Insurance
Pharmaceuticals
Mental Healthcare
Elder Care
Rehabilitation Services
Medical Research
Healthcare Technology
Medical Education
Public Health
Legal
Compliance
Medical Records
Patient Services
Administration
Clinical Operations
Quality Assurance
Risk Management
Privacy and Security
Patient Relations
Medical Doctor
Nurse Practitioner
Healthcare Administrator
Medical Records Officer
Compliance Officer
Privacy Officer
Healthcare Facility Manager
Medical Secretary
Clinical Coordinator
Patient Relations Manager
Legal Counsel
Medical Insurance Coordinator
Healthcare Quality Manager
Medical Information Officer
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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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