Consent To Disclose Information Form Template for Singapore

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Key Requirements PROMPT example:

Consent To Disclose Information Form

"I need a Consent To Disclose Information Form for my medical clinic in Singapore to share patient records with a specialist hospital, ensuring PDPA compliance and including specific provisions for sharing diagnostic images and test results."

Document background

The Consent To Disclose Information Form is essential for organizations operating in Singapore that need to share personal data with third parties. This document ensures compliance with the Personal Data Protection Act 2012 (PDPA) by obtaining explicit consent from individuals before their information is disclosed. The form typically includes details about what information will be shared, who will receive it, how it will be used, and the duration of the consent. It serves as evidence of compliance with Singapore's data protection requirements and helps organizations manage their data disclosure obligations effectively.

Suggested Sections

1. Individual's Information: Basic details of the person giving consent including name, identification number, contact details

2. Purpose of Disclosure: Clear statement of why the information is being collected and how it will be used, in compliance with PDPA requirements

3. Information to be Disclosed: Specific details of what personal data will be shared, including categories of data

4. Recipient Information: Details of organizations or persons who will receive the information

5. Consent Declaration: Express statement of consent with signature block and date

Optional Sections

1. Duration of Consent: Time period for which consent remains valid, including expiry date if applicable

2. Third Party Authorization: Authorization for sharing information with additional parties beyond primary recipient

3. Withdrawal Procedure: Detailed process for withdrawing consent, including contact information and timeframes

Suggested Schedules

1. Schedule A - Detailed Data Fields: Comprehensive list of specific data fields to be disclosed

2. Schedule B - Privacy Policy Reference: Organization's privacy policy or relevant excerpts pertaining to data handling

3. Schedule C - Contact Information: Contact details for data protection officer or relevant department handling data protection matters

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
Financial Services
Education
Employment
Insurance

Relevant Teams

Legal
Compliance
Human Resources
Data Protection
Information Technology

Relevant Roles

Data Protection Officer
Compliance Manager
HR Manager
Privacy Officer
Legal Counsel

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Let's create your Consent To Disclose Information Form

Authors

Alex Denne

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