Permission To Release Information Form

Permission To Release Information Form Template for Switzerland

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Key Requirements PROMPT example:

"I need a Permission to Release Information Form for my medical records that allows sharing between my primary care physician in Zurich and three specialist clinics in Basel throughout 2025, with specific provisions for sharing diagnostic imaging and treatment plans."

Document background

The Permission To Release Information Form is a critical document used in Switzerland when personal data needs to be shared between parties while maintaining compliance with Swiss data protection laws. This document becomes necessary when an individual needs to authorize the release of their personal information, whether for medical records, financial data, educational records, or other sensitive information. The form must comply with the Swiss Federal Act on Data Protection (FADP) and its revised version (RevFADP), which set strict requirements for data processing and transfer. It's particularly important in situations where explicit consent is required for data sharing, such as in healthcare settings, financial institutions, or educational establishments. The Permission To Release Information Form serves as both a legal authorization and a record of consent, protecting the rights of the data subject while providing necessary documentation for the information holder and recipient.

Suggested Sections

1. Identifying Information: Details of the person giving permission (name, address, date of birth, contact information, and any relevant identification numbers)

2. Information Holder: Details of the organization/entity currently holding the information that is to be released

3. Recipient Information: Details of the person(s) or organization(s) to whom the information may be released

4. Scope of Information: Specific description of what information is authorized to be released, including date ranges if applicable

5. Purpose of Release: Clear statement of why the information is being released and how it will be used

6. Duration of Authorization: Time period for which the authorization is valid, including start and end dates

7. Rights and Revocation: Statement of the individual's rights, including the right to revoke authorization and the process for doing so

8. Signatures: Space for dated signatures of the authorizing individual and any required witnesses

Optional Sections

1. Special Categories of Data: Additional specific permissions for sensitive data categories (health, financial, etc.) - include when sensitive personal data is involved

2. Cross-border Transfer Consent: Specific consent for international data transfers - include when information may be transferred outside Switzerland

3. Third Party Access: Provisions for allowing or restricting access by third parties - include when third-party access might be relevant

4. Electronic Processing Consent: Specific consent for electronic processing and storage - include when digital processing is involved

5. Translation Declaration: Statement confirming the individual understands the content if the form is in multiple languages - include for multilingual forms

Suggested Schedules

1. Detailed Information List: Itemized list of specific documents or information types to be released, particularly when the scope is extensive

2. Authorized Recipients List: Detailed list of all authorized recipients and their contact information, when multiple recipients are involved

3. Privacy Notice: Detailed privacy notice explaining how the information will be handled, stored, and protected by the recipient(s)

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 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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