Release Request Form Template for Singapore

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Key Requirements PROMPT example:

Release Request Form

"I need a Release Request Form for requesting access to my complete medical records from Singapore General Hospital, with authorization for my insurance company to receive copies directly, to be effective from March 15, 2025."

Document background

The Release Request Form is a essential document used in Singapore's business and legal environment when formal authorization is needed to release specific information, documents, or items. This document is designed to comply with Singapore's stringent data protection laws, particularly the Personal Data Protection Act 2012, and provides a clear audit trail of release requests and authorizations. The Release Request Form typically includes detailed information about the requestor, the specific items requested for release, intended use, and any applicable restrictions or conditions. It serves as both a formal request mechanism and a record of authorization, protecting both the releasing and requesting parties.

Suggested Sections

1. Requestor Information: Full details of the person/entity requesting the release including name, contact information, and any relevant identification numbers

2. Subject Matter: Clear and specific description of what is being released (documents, rights, claims, etc.)

3. Purpose Statement: Explicit statement of the purpose for which the release is being requested

4. Timeline and Deadlines: Specific dates for when the release is requested and any relevant deadlines or time constraints

5. Declaration: Statement confirming the truthfulness and accuracy of the information provided

Optional Sections

1. Confidentiality Statement: Section detailing confidentiality obligations and handling of sensitive information

2. Third Party Authorization: Section for cases where the release is requested on behalf of another party

3. Usage Restrictions: Specific limitations and conditions on how released items may be used

4. PDPA Consent: Specific consent section for personal data collection, use, and disclosure under Singapore's PDPA

Suggested Schedules

1. Schedule A - Identification Documents: Copies of relevant identification or authorization documents

2. Schedule B - Itemized List: Detailed inventory of items or documents requested for release

3. Schedule C - Authorization Letters: Required authorization documents from third parties or regulatory bodies

4. Schedule D - Supporting Documents: Any additional documentation supporting the release request

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

Authorized Representative
Confidential Information
Data Protection Laws
Effective Date
Information Owner
PDPA
Personal Data
Release Date
Released Information
Released Items
Releasing Party
Request
Requestor
Restricted Information
Subject Matter
Third Party Recipient
Transfer Method
Usage Purpose

Clauses

Relevant Industries

Healthcare
Financial Services
Education
Legal Services
Human Resources

Relevant Teams

Legal
Compliance
Records Management
Human Resources
Information Technology

Relevant Roles

Compliance Officer
Data Protection Officer
Legal Counsel
Records Manager
Human Resources Manager

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Let's create your Release Request Form

Authors

Alex Denne

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