Consent And Declaration Form Template for Singapore

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Key Requirements PROMPT example:

Consent And Declaration Form

"I need a Consent and Declaration Form for my medical research study in Singapore, which will involve collecting sensitive health data from participants over 65 years old starting from March 2025, with specific provisions for withdrawal of consent."

Document background

The Consent And Declaration Form is a critical document used in Singapore when organizations need to obtain explicit consent and/or formal declarations from individuals. This document is particularly important given Singapore's strict data protection regime under the PDPA 2012 and the increasing need for documented consent in various transactions. The form serves as legal evidence of consent given and declarations made, protecting both the organization and the individual. It typically includes personal information, specific consents sought, declarations made, and acknowledgment of understanding, with provisions for withdrawal of consent where applicable.

Suggested Sections

1. Personal Information: Details of the person giving consent/making declaration including name, identification number, contact details

2. Purpose Statement: Clear explanation of why consent is being sought and how the information/consent will be used

3. Scope of Consent: Specific details of what is being consented to, including any limitations or conditions

4. Declaration Statements: Specific statements being declared as true, with each statement clearly numbered and detailed

5. Acknowledgment: Confirmation that the person understands and voluntarily provides consent, including PDPA acknowledgments

6. Signature Block: Space for signature, date, and witness details if required, including electronic signature provisions

Optional Sections

1. Withdrawal of Consent: Process and conditions for withdrawing consent, applicable for ongoing consent relationships

2. Third Party Authorization: Authorization section for cases where a third party needs to act on behalf of the declarant

3. Witness Section: Additional section for witness details and signature when witnessing is required

4. Parent/Guardian Consent: Additional consent section for cases involving minors or persons lacking capacity

Suggested Schedules

1. List of Authorized Activities: Detailed schedule listing specific activities, uses, or disclosures being consented to

2. Supporting Documents: Schedule listing required supporting documents and declarations

3. Terms and Conditions: Detailed terms and conditions applicable to the consent and declaration

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

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Authors

Alex Denne

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