Authorization For Release Of Information Form Template for Malaysia

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Key Requirements PROMPT example:

Authorization For Release Of Information Form

"I need an Authorization for Release of Information Form for my medical clinic in Kuala Lumpur that allows us to share patient records with specialist hospitals, ensuring compliance with Malaysian healthcare regulations and including specific provisions for digital record transfers."

Document background

The Authorization For Release of Information Form is a crucial document used in Malaysia when there's a need to legally share confidential information between parties. This document becomes necessary in various scenarios, such as medical record transfers, financial information sharing, or employment verification processes. It must comply with Malaysian legislation, particularly the Personal Data Protection Act 2010, which governs how personal data can be collected, processed, and disclosed. The form serves as a protective measure for all parties involved, clearly defining the scope of information to be shared, the purpose of disclosure, and the duration of the authorization. This document is essential for organizations to maintain compliance with privacy laws while facilitating necessary information sharing.

Suggested Sections

1. Title and Date: Clear identification of the document as an Authorization for Release of Information Form and the date of execution

2. Authorizing Party Details: Full name, identification number (IC/passport), and contact details of the person authorizing the release of information

3. Recipient Party Details: Name and details of the organization/person authorized to receive the information

4. Information Holder Details: Name and details of the organization/person currently holding the information who is authorized to release it

5. Scope of Authorization: Specific description of what information is authorized to be released

6. Purpose of Disclosure: Clear statement of why the information is being released and how it will be used

7. Duration of Authorization: The period for which the authorization remains valid

8. Rights and Revocation: Statement of the authorizing party's rights including the right to revoke the authorization

9. Signature Block: Space for signatures of the authorizing party, witness(es), and date of signing

Optional Sections

1. Medical Information Specifics: Additional section when the authorization involves medical records, including specific health information to be released and relevant healthcare providers

2. Financial Information Details: Additional section when the authorization involves financial records, specifying account numbers or types of financial information

3. Third Party Authorization: Section needed when the authorizing party is acting on behalf of another person (e.g., parent for child, guardian for ward)

4. Confidentiality Agreement: Additional provisions regarding confidentiality obligations of the recipient when handling sensitive information

5. Electronic Transmission Authorization: Specific authorization for electronic transmission of information when applicable

Suggested Schedules

1. Schedule A - Types of Information: Detailed list of specific information types authorized for release, particularly useful for complex authorizations involving multiple categories of information

2. Schedule B - Authorized Recipients List: List of all authorized recipients when multiple parties are involved

3. Appendix 1 - Identity Verification Documents: Copies of identity documents required to verify the authorizing party's identity

4. Appendix 2 - Supporting Documentation: Any additional documents supporting the authorization (e.g., power of attorney, court orders)

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

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Healthcare

Banking and Finance

Insurance

Education

Employment

Legal Services

Real Estate

Government Services

Telecommunications

Professional Services

Relevant Teams

Legal

Compliance

Human Resources

Medical Records

Information Security

Risk Management

Operations

Administrative Services

Data Protection

Corporate Governance

Relevant Roles

Legal Counsel

Compliance Officer

Human Resources Manager

Medical Records Administrator

Privacy Officer

Data Protection Officer

Risk Manager

Healthcare Administrator

Financial Services Manager

Operations Manager

Records Manager

Administrative Coordinator

Corporate Secretary

Information Security Officer

Find the exact document you need

Authorisation Form

A Malaysian legal document granting specific powers or permissions from an authorizer to an authorized representative, compliant with Malaysian contract law.

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Let's create your Authorization For Release Of Information Form

Authors

Alex Denne

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