Protected Health Information Form Template for Singapore

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Key Requirements PROMPT example:

Protected Health Information Form

"I need a Protected Health Information Form for my new digital health clinic in Singapore that will collect patient data through a mobile app, with specific provisions for data encryption and cross-border transfers to our US-based cloud storage provider, to be implemented by March 2025."

Document background

The Protected Health Information Form is essential for healthcare providers operating in Singapore to ensure compliance with data protection regulations while managing patient information. This document is required whenever protected health information is collected, used, or disclosed, and must align with both the Personal Data Protection Act (PDPA) and Healthcare Services Act (HCSA). It provides a framework for consent, outlines data protection measures, and establishes rights and responsibilities for all parties involved in handling sensitive health information.

Suggested Sections

1. Patient Information: Basic demographic and contact information of the patient

2. Consent Declaration: Express consent for collection, use, and disclosure of health information

3. Purpose of Collection: Specific purposes for which the health information will be collected and used

4. Data Protection Measures: Description of security measures to protect health information

5. Rights and Access: Patient's rights regarding their health information

Optional Sections

1. International Transfer Provisions: Required when health information may be transferred outside Singapore

2. Research Consent: Additional consent for use of health information in research

3. Third Party Access: Provisions for sharing information with third parties

Suggested Schedules

1. Schedule A: Detailed Data Categories: List of specific types of health information to be collected

2. Schedule B: Authorized Recipients: List of authorized parties who may receive the health information

3. Appendix 1: Security Protocols: Detailed description of data security measures

4. Appendix 2: Patient Rights Guide: Detailed explanation of patient rights regarding their health information

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
Medical Research
Insurance
Digital Health

Relevant Teams

Legal
Compliance
Medical Records
Information Technology
Administration

Relevant Roles

Data Protection Officer
Healthcare Administrator
Medical Records Manager
Compliance Officer
Privacy Officer

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Let's create your Protected Health Information Form

Authors

Alex Denne

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