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Statement Of Consent Form

Statement Of Consent Form Template for Australia

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Key Requirements PROMPT example:

Statement Of Consent Form

"I need a Statement of Consent Form for a medical research study starting in March 2025, which will involve collecting blood samples and health data from participants aged 18-65 in Sydney, with specific provisions for data sharing with international research partners."

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Document background
The Statement of Consent Form is a critical document used across various sectors in Australia to ensure compliance with privacy laws and consent requirements. This document is essential when organizations or individuals need to obtain explicit, informed consent for activities such as medical procedures, research participation, data collection, or media usage. The form must comply with the Privacy Act 1988 (Cth), Australian Privacy Principles, and relevant state-specific legislation. It typically includes detailed information about the purpose of consent, rights of the consenting party, privacy considerations, and withdrawal procedures. Organizations use this document to demonstrate compliance with legal requirements, manage risk, and maintain transparent relationships with stakeholders. The Statement of Consent Form should be regularly reviewed and updated to reflect changes in legislation and best practices in consent management.
Suggested Sections

1. Title and Date: Clear identification of the document as a Statement of Consent with the date of execution

2. Parties: Details of the person giving consent (the consenting party) and the organization/individual seeking consent (including relevant contact information)

3. Purpose of Consent: Clear explanation of what the consent is for and why it is being sought

4. Nature of Consent: Specific details of what is being consented to, including scope and duration

5. Rights and Obligations: Explanation of the rights of the consenting party, including the right to withdraw consent

6. Privacy Notice: Information about how personal data will be collected, used, stored, and protected

7. Declaration: Formal statement confirming understanding and voluntary consent

8. Execution: Signature blocks for all parties, including date and witness if required

Optional Sections

1. Interpreter Declaration: Required when the consent form is explained through an interpreter

2. Guardian Consent: Required when consent is being given by a legal guardian or authorized representative

3. Withdrawal Process: Detailed process for withdrawing consent, included when the consent relates to ongoing activities

4. Risk Disclosure: Required for medical procedures or high-risk activities

5. Third Party Disclosures: Required when personal information will be shared with other organizations

6. Emergency Contacts: Included when the consent relates to medical procedures or high-risk activities

7. Photographic/Media Consent: Required when images or recordings of the person may be taken or used

Suggested Schedules

1. Schedule A - Detailed Description: Comprehensive description of the activity, procedure, or data processing being consented to

2. Schedule B - Privacy Policy: Full privacy policy or detailed privacy information referenced in the main consent form

3. Schedule C - Risk Assessment: Detailed outline of potential risks and mitigation measures

4. Appendix 1 - Glossary: Definitions of technical terms or medical terminology used in the consent form

5. Appendix 2 - Supporting Documentation: Copies of relevant certificates, qualifications, or additional information referenced in the main form

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
Consent
Personal Information
Sensitive Information
Health Information
Authorized Representative
Capacity
Withdrawal of Consent
Privacy Notice
Data Collection
Data Processing
Third Party
Service Provider
Consenting Party
Guardian
Disclosed Information
Confidential Information
Purpose
Effective Date
Witness
Identity Verification
Informed Consent
Legal Representative
Privacy Policy
Records
Regulated Activity
Material Change
Permitted Purpose
Data Recipient
Jurisdiction
Force Majeure
Relevant Industries

Healthcare

Education

Financial Services

Research

Clinical Trials

Social Services

Media and Entertainment

Professional Services

Sports and Recreation

Childcare

Aged Care

Mental Health Services

Technology

Marketing and Advertising

Relevant Teams

Legal

Compliance

Risk Management

Human Resources

Operations

Clinical Administration

Research Administration

Data Protection

Patient Services

Corporate Governance

Marketing

Information Technology

Quality Assurance

Relevant Roles

Legal Counsel

Privacy Officer

Compliance Manager

Risk Manager

Medical Administrator

Research Coordinator

Human Resources Manager

Data Protection Officer

Clinical Trial Coordinator

Project Manager

Operations Manager

Patient Services Manager

Education Administrator

Marketing Manager

Corporate Secretary

Industries
Privacy Act 1988 (Cth): Federal legislation governing the collection, use, storage and disclosure of personal information, including requirements for informed consent and privacy notices
Australian Privacy Principles (APPs): 13 principles under the Privacy Act that set out standards, rights and obligations for handling personal information, including consent requirements
State Health Records Acts: State-specific legislation (varies by state) governing the handling of health information and consent requirements for medical procedures
Guardianship Acts: State-based legislation governing consent for individuals who lack capacity to make their own decisions
Electronic Transactions Act 1999: Legislation governing electronic signatures and digital consent, relevant for electronic consent forms
Age of Majority Acts: State-specific legislation determining the age at which an individual can provide legal consent
Australian Consumer Law: Relevant for consent forms in commercial contexts, ensuring transparency and fairness in consumer agreements
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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