General Authorisation To Release Information Form Template for England and Wales

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Key Requirements PROMPT example:

General Authorisation To Release Information Form

"I need a General Authorisation To Release Information Form that allows my medical records to be shared between my current GP and a specialist consultant for a period of 6 months starting from January 2025, with specific provisions for maintaining confidentiality of mental health records."

Document background
The General Authorisation To Release Information Form serves as a crucial document in situations where controlled sharing of personal information is required. This form, governed by English and Welsh law, ensures compliance with data protection regulations while facilitating necessary information exchange. It is commonly used when individuals need to authorize third parties to access their personal records, whether for medical, financial, educational, or other purposes. The document provides clear parameters for information sharing, including scope, duration, and permitted uses, while maintaining appropriate privacy safeguards.
Suggested Sections

1. Subject Information: Full details of the person whose information is being released, including full name, address, date of birth, and any relevant identification numbers

2. Authorisation Statement: Clear and explicit statement of consent authorizing the release of specified information, acknowledging understanding of data protection rights

3. Information Scope: Detailed description of what information can be released, including type of information, time period covered, and any specific exclusions

4. Recipient Details: Complete information about who is authorized to receive the information, including organization name, contact person, address and contact details

5. Duration: Specific timeframe for which the authorization remains valid, including start date and expiration date

6. Signature Block: Space for formal execution including date, signature of the subject, witness signature if required, and any notarization requirements

Optional Sections

1. Purpose Statement: Specific purpose for which the released information can be used, including any restrictions on use or further disclosure

2. Third Party Authorization: Details and authority of any third parties authorized to act on behalf of the subject, including relationship to subject and scope of authority

3. Revocation Clause: Detailed process for withdrawing consent, including contact information and any notice requirements

4. Data Protection Notice: Information about rights under data protection laws, including right to withdraw consent and lodge complaints with supervisory authorities

Suggested Schedules

1. Schedule A - List of Specific Records: Detailed inventory of specific documents, records, or information to be released, including dates and reference numbers where applicable

2. Schedule B - Proof of Identity: Requirements and copies of acceptable identification documents to verify the identity of the subject

3. Schedule C - Power of Attorney: Where applicable, documentation proving legal authority to act on behalf of the subject, including any restrictions or limitations

4. Schedule D - Privacy Notice: Detailed information about how the released information will be processed, stored, and protected by the recipient

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: The UK's primary data protection legislation that implements data protection standards, sets out rules for processing personal data, and defines the rights of data subjects

UK General Data Protection Regulation (UK GDPR): Post-Brexit adaptation of EU GDPR that establishes fundamental principles of data processing, legal bases for processing personal data, and requirements for valid consent

Freedom of Information Act 2000: Legislation governing right of access to information held by public authorities, relevant when the information holder is a public body

Access to Health Records Act 1990: Specific legislation governing access to medical information and health records, including rules for their disclosure and handling

Human Rights Act 1998: Incorporates Article 8 (right to privacy) and requires balance between privacy rights and information sharing in UK law

Mental Capacity Act 2005: Legislation governing decision-making for individuals who lack capacity to provide consent, including rules for authorized representatives

Common Law Duty of Confidentiality: Fundamental legal principle establishing obligations of confidentiality and circumstances where disclosure is permitted

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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