Create a bespoke document in minutes, or upload and review your own.
Get your first 2 documents free
Your data doesn't train Genie's AI
You keep IP ownership of your information
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."
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
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
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
Confidential Information
Data Controller
Data Protection Laws
Healthcare Provider
Immunization Records
Medical Records
Patient
Patient Representative
Personal Data
Protected Health Information
Record Holder
Release Authorization
Specified Purpose
Third Party Recipient
Valid Identification
Vaccination History
Find the exact document you need
Authorisation Of Release Of Unemployment Records Form
A legal form used in England and Wales to authorize the release of individual unemployment records in compliance with UK data protection laws.
Authorisation For Release Of Records
A legal document under English and Welsh law authorizing the release of specific records from one party to another, in compliance with UK data protection legislation.
Release Of Information Statement
A legal document under English and Welsh law authorizing and governing the release of specific information between parties while ensuring data protection compliance.
Printable Work Release Form
A legally binding document under English and Welsh law that formalizes the termination of employment and mutual release of claims between employer and employee.
Dental Release Of Information Form
A legal document under English and Welsh law authorizing the release of dental records and information to specified parties.
Work Release Form From Doctor
A medical document used in England and Wales certifying an employee's fitness to return to work, compliant with UK healthcare and employment regulations.
Universal Medical Release Form
A legal document under English and Welsh law authorizing the release of medical records to specified parties while ensuring data protection compliance.
Service Release Form
A legally binding document under English and Welsh law that releases parties from obligations and liabilities related to completed services.
Revocation Of Release Of Information Form
An English and Welsh law-compliant document for withdrawing previously granted authorization for information sharing and processing.
Release Form For Video Recording
A legal document under English and Welsh law that obtains consent for video recording and establishes usage rights for the recorded content.
Download our whitepaper on the future of AI in Legal
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
Our bank-grade security infrastructure undergoes regular external audits
We are ISO27001 certified, so your data is secure
Organizational security
You retain IP ownership of your documents
You have full control over your data and who gets to see it
Innovation in privacy:
Genie partnered with the Computational Privacy Department at Imperial College London
Together, we ran a £1 million research project on privacy and anonymity in legal contracts
Want to know more?
Visit our Trust Centre for more details and real-time security updates.
Read our Privacy Policy.