Authorisation To Release Immunization Records Template for England and Wales

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Key Requirements PROMPT example:

Authorisation To Release Immunization Records

"I need an Authorisation To Release Immunization Records for my daughter's school enrollment, allowing her GP to share her vaccination history with her new primary school from January 2025, ensuring all her recent COVID-19 and standard childhood vaccinations are included."

Document background
The Authorisation To Release Immunization Records is essential in situations where proof of vaccination history is required for educational enrollment, employment, travel, or healthcare purposes. This document, compliant with English and Welsh law, provides a standardized method for requesting and releasing immunization records while maintaining data protection requirements. It includes specific details about the records to be released, the parties involved, and the duration of the authorization, ensuring clear consent and proper handling of sensitive medical information.
Suggested Sections

1. Patient Information: Full name, date of birth, NHS number, current address of the patient

2. Authorization Statement: Clear statement of consent to release immunization records, including reference to relevant data protection legislation

3. Recipient Information: Details of person/organization authorized to receive the immunization records

4. Record Scope: Specific immunization records being authorized for release and time period covered

5. Duration of Authorization: Time period for which the authorization remains valid

6. Signature Block: Patient signature, date, and witness signature space if required

Optional Sections

1. Purpose of Release: Optional section specifying the reason for requesting records, used when relevant to recipient's needs

2. Parent/Guardian Authorization: Additional section required when patient is under 16 or lacks capacity to provide consent

3. Special Instructions: Optional section for any specific handling or delivery instructions for the records

4. Data Protection Notice: Optional detailed section about how the information will be processed and protected under UK GDPR and DPA 2018

Suggested Schedules

1. Identity Verification Documents: Schedule for attaching copies of accepted ID documents to verify patient identity

2. Proof of Authority Documentation: Schedule for documentation required when request is made by guardian or person with power of attorney

3. List of Authorized Records: Detailed schedule specifying exact immunization records authorized for release

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

Industries

Data Protection Act 2018: UK's primary data protection legislation that implements UK GDPR requirements, regulates handling of personal data including health records, and establishes data subject rights and consent requirements

UK General Data Protection Regulation: Defines health data as special category data requiring enhanced protection, establishes principles for lawful data processing, and sets requirements for explicit consent

Access to Health Records Act 1990: Governs access to health records and includes specific provisions for handling deceased patients' records

Public Health (Control of Disease) Act 1984: Establishes immunization record keeping requirements and public health reporting obligations

National Health Service Act 2006: Provides framework for NHS record-keeping and information governance requirements

Caldicott Principles: Guidelines specifically designed for handling patient information in the NHS, including confidentiality requirements

Professional Standards and Guidelines: Includes guidance from General Medical Council (GMC), Nursing and Midwifery Council (NMC) standards, and NHS Digital guidelines for healthcare professionals

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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