Release Of Medical Records To Family Members Form Template for Hong Kong

1. Mental Capacity Declaration: Required when the patient lacks mental capacity to make decisions, including details of the legal authority making decisions on their behalf

2. Emergency Contact Provisions: Special provisions for emergency situations where immediate access to records might be needed

3. Digital Access Authorization: Specific provisions for electronic access to medical records through hospital portals or electronic systems

4. Translation Declaration: Required when the form has been translated or when translation services were used during the authorization process

5. Minor Patient Provisions: Special provisions when the patient is under 18, including parental authority details

1. Schedule A: Types of Medical Records: Detailed list of different types of medical records that can be accessed (e.g., consultation notes, test results, imaging reports)

2. Schedule B: Identification Requirements: List of acceptable identification documents for both patient and authorized family members

3. Schedule C: Privacy Notice: Detailed privacy notice explaining how the medical information will be protected and used

4. Appendix 1: Revocation Form: Standard form for revoking the authorization

5. Appendix 2: Hospital Locations: List of hospital facilities where this authorization can be used