Release Of Medical Records To Family Members Form Template for England and Wales

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Key Requirements PROMPT example:

Release Of Medical Records To Family Members Form

"I need a Release Of Medical Records To Family Members Form to allow my sister access to my elderly mother's medical records from January 2025 onwards, as she will be her primary caregiver and needs to coordinate with multiple healthcare providers."

Document background
The Release Of Medical Records To Family Members Form is a critical document used in England and Wales to facilitate authorized access to medical records while protecting patient privacy. This form becomes necessary when family members require access to a patient's medical information, whether for ongoing care coordination, legal purposes, or other legitimate reasons. It ensures compliance with the Data Protection Act 2018, UK GDPR, and the Common Law Duty of Confidentiality. The form includes specific provisions for various scenarios, including cases where the patient lacks capacity or is deceased, and requires proper identification and authorization verification.
Suggested Sections

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

2. Authorized Family Member Details: Full name, relationship to patient, contact details of the family member requesting access

3. Scope of Authorization: Specific medical records being authorized for release, including date ranges if applicable

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

5. Declaration and Signature: Patient's confirmation and signature, or authorized representative's signature if patient lacks capacity

Optional Sections

1. Third Party Information Exclusion: Section addressing handling of third-party information within medical records, used when records might contain information about other individuals

2. Mental Capacity Statement: Used when patient lacks capacity, including details of the person authorized to act on their behalf

3. Deceased Patient Information: Used for accessing records of deceased patients, including proof of executor status or relationship

Suggested Schedules

1. Identity Verification Documents: List of acceptable ID documents and copies of provided identification

2. Proof of Authority: Documentation proving authority to act (e.g., Power of Attorney, Court Order)

3. Record Request Details: Detailed list of specific records being requested

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: Primary UK data protection legislation that implements UK GDPR requirements and regulates how personal data, including medical information, should be handled. Sets out data subject rights and conditions for lawful processing.

UK General Data Protection Regulation (UK GDPR): Core regulation governing the processing of personal data in the UK, establishing principles for data processing and defining special category data including health information.

Access to Health Records Act 1990: Legislation specifically governing access to medical records, particularly relevant for accessing records of deceased patients and defining who can access medical records after death.

Mental Capacity Act 2005: Legislation relevant when patients lack capacity to consent, determining who can make decisions on behalf of individuals lacking mental capacity.

Common Law Duty of Confidentiality: Legal principle governing medical professionals' obligations to maintain patient confidentiality and establishing the basis for sharing information with consent.

NHS Act 2006: Legislation containing specific provisions about the handling of NHS patient information and healthcare data management.

Caldicott Principles: Guidelines established for handling patient-identifiable information within the NHS, providing framework for information governance in healthcare.

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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