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Release And Authorization Form
"I need a Release and Authorization Form under Singapore law for our medical clinic to obtain patient consent for both treatment procedures and sharing medical data with affiliated specialists, to be implemented by March 2025."
1. Introduction: Identifies the parties and date of execution
2. Scope of Release: Clearly defines what is being released and the extent of the release
3. Authorization Details: Specific permissions being granted and their scope
4. Consideration: States what is being given in exchange for the release
5. Acknowledgment: Confirming understanding and voluntary nature of the release
6. Signature Block: Space for signatures, dates, and witness details if required
1. Definitions: Used when technical or specific terms need clear definition - recommended for complex releases with specific terminology
2. Indemnification: Additional protection against future claims - recommended for high-risk releases or where significant liability exists
3. Confidentiality: Terms regarding confidential information - recommended when sensitive information is involved
4. Dispute Resolution: Process for handling disagreements - recommended for complex releases or high-value matters
1. Description of Released Claims: Detailed list of specific claims being released
2. Authorized Activities: Detailed list of permitted activities under the authorization
3. Supporting Documentation: Any relevant documents referenced in the main agreement
Authors
Releasee
Effective Date
Released Claims
Released Parties
Authorized Activities
Authorized Period
Confidential Information
Personal Data
Claims
Liability
Indemnified Parties
Subject Matter
Authorization Scope
Permitted Purpose
Related Entities
Applicable Law
Force Majeure Event
Territory
Material Breach
Consent
Representatives
Authorization Grant
Scope of Release
Scope of Authorization
Consideration
Representations and Warranties
Acknowledgments
Indemnification
Confidentiality
Data Protection
Liability Limitations
Waiver
Severability
Governing Law
Dispute Resolution
Amendment and Modification
Entire Agreement
Assignment
No Admission of Liability
Revocation Rights
Notice Requirements
Third Party Rights
Force Majeure
Execution
Survival
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