Consent To Share Form Template for New Zealand

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Key Requirements PROMPT example:

Consent To Share Form

"I need a Consent to Share Form for my medical practice in Auckland that allows sharing of patient records with specialists and other healthcare providers, including provisions for emergency access and digital health records."

Document background

The Consent to Share Form is a crucial document used in New Zealand to ensure compliance with privacy legislation, particularly the Privacy Act 2020, when sharing personal information between organizations or individuals. This document is essential when an organization needs to obtain explicit permission to share an individual's personal information with third parties. The form should be used whenever personal information needs to be shared beyond the primary purpose for which it was collected, or when sharing sensitive information such as health records, financial details, or educational information. It provides transparency about how information will be used and shared, protects both the organization and the individual, and creates a clear audit trail of consent. The document must align with New Zealand's privacy principles and should be regularly reviewed to ensure ongoing compliance with privacy legislation.

Suggested Sections

1. Party Details: Identification of the individual whose information will be shared (data subject) and the organization requesting consent

2. Background: Brief context explaining why the information sharing is necessary

3. Definitions: Clear explanations of key terms used in the form

4. Purpose of Information Sharing: Specific explanation of why the information needs to be shared and how it will be used

5. Information to be Shared: Detailed description of exactly what information will be shared

6. Recipients of Information: Clear identification of who will receive the information

7. Privacy Rights Statement: Statement of the individual's rights under the Privacy Act 2020

8. Consent Declaration: Clear statement of consent with signature block

9. Revocation Rights: Information about how to withdraw consent

Optional Sections

1. Time Limitations: Section specifying time limits on the consent - used when consent should expire after a certain period

2. Special Handling Requirements: Additional requirements for sensitive information - used when sharing sensitive personal or health information

3. Third Party Consent: Additional section for when consent is given by someone other than the data subject (e.g., parent/guardian)

4. Digital Privacy Provisions: Specific provisions for digital data sharing - used when information will be shared electronically

5. Emergency Contact Details: Contact information for emergencies - used in medical or care-related contexts

Suggested Schedules

1. Schedule 1 - Detailed Information List: Comprehensive list of specific information items to be shared

2. Schedule 2 - Authorized Recipients: Detailed list of organizations and individuals authorized to receive the information

3. Schedule 3 - Privacy Policy: Organization's privacy policy or relevant excerpts

4. Appendix A - Consent Withdrawal Form: Template form for withdrawing consent

5. Appendix B - Information Handling Protocols: Detailed procedures for how shared information will be handled and protected

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

Relevant Industries

Healthcare

Education

Financial Services

Social Services

Government Services

Professional Services

Insurance

Legal Services

Aged Care

Child Care

Mental Health Services

Disability Services

Relevant Teams

Legal

Compliance

Privacy

Human Resources

Information Security

Risk Management

Customer Service

Records Management

Clinical Administration

Operations

Data Management

Relevant Roles

Privacy Officer

Compliance Manager

Legal Counsel

Data Protection Officer

Healthcare Administrator

Social Worker

Human Resources Manager

Customer Service Manager

Records Manager

Information Security Officer

Risk Manager

Clinical Director

Education Administrator

Financial Advisor

Case Manager

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Authors

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