tiktok成人版

Authorisation For Disclosure Of Protected Health Information Form Template for England and Wales

Create a bespoke document in minutes, 聽or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Authorisation For Disclosure Of Protected Health Information Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership聽of your information

Key Requirements PROMPT example:

Authorisation For Disclosure Of Protected Health Information Form

"I need an Authorisation For Disclosure Of Protected Health Information Form for a clinical trial starting in March 2025, which will allow our research institution to access patient records from multiple NHS trusts while ensuring GDPR compliance and including specific provisions for data anonymization."

Document background
The Authorisation For Disclosure Of Protected Health Information Form is essential in healthcare settings across England and Wales where patient confidentiality must be maintained while facilitating necessary information sharing. This document is required when medical records or health information needs to be shared with third parties, whether for continued care, legal proceedings, insurance purposes, or research. It ensures compliance with UK data protection laws and healthcare regulations while providing a clear audit trail of consent. The form includes specific details about what information can be shared, with whom, for what purpose, and for how long.
Suggested Sections

1. Patient Information: Full name, date of birth, address, NHS number, contact details

2. Healthcare Provider Details: Name and address of the healthcare provider holding the information

3. Information to be Disclosed: Specific description of medical information to be shared

4. Purpose of Disclosure: Reason for requesting information disclosure

5. Recipient Details: Who will receive the information

6. Duration of Authorization: Time period for which authorization is valid

7. Rights Statement: Patient's rights including right to revoke authorization

Optional Sections

1. Representative Authorization: Additional section required when someone other than the patient is authorizing the disclosure (e.g., legal representative or next of kin)

2. Specific Exclusions: Section for specifying particular information that the patient explicitly does not want shared

3. Emergency Contact: Section for alternative contact details when an additional point of contact is needed

Suggested Schedules

1. Identity Verification Requirements: List of acceptable identification documents and verification process

2. Fee Schedule: Schedule detailing any applicable costs associated with information provision

3. Privacy Notice: Detailed information about data protection rights and processes under UK GDPR and DPA 2018

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions




























Clauses
























Industries

UK GDPR: UK General Data Protection Regulation - Primary legislation governing personal data processing and protection in the UK post-Brexit

Data Protection Act 2018: UK's implementation of data protection standards, working alongside UK GDPR to regulate personal data processing

Access to Health Records Act 1990: Legislation providing rights of access to health records of deceased patients and regulating health records management

Mental Capacity Act 2005: Framework for making decisions on behalf of individuals who lack mental capacity to make specific decisions

Health and Social Care Act 2012: Legislation governing the structure and function of the NHS, including information governance requirements

Common Law Duty of Confidentiality: Legal obligation requiring healthcare professionals to protect patient confidentiality and only disclose information with consent or legal justification

Caldicott Principles: Set of principles governing how patient information should be used in healthcare settings and shared with other organizations

NHS Act 2006: Primary legislation establishing the framework for NHS services, including provisions for information handling

GMC Guidance on Confidentiality: Professional guidelines from the General Medical Council on managing patient confidentiality and information disclosure

BMA Guidelines: British Medical Association's professional guidance on medical ethics and information handling

NHS Digital Guidelines: Specific guidance on information governance within the NHS, including technical standards for data protection

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Vehicle Release Form Towing

find out more

Vehicle Release Authorisation Form

find out more

Vehicle Property Release Form

find out more

Transcript Release Authorisation

find out more

Temporary Medical Permission Form

find out more

Temporary Guardian Medical Release Form

find out more

Simple Release Form

find out more

Simple Medical Release Form

find out more

Simple Medical Consent Form

find out more

Return To Work Medical Release

find out more

Release Of Medical Records To Family Members Form

find out more

Release Of Information Form For Rental History

find out more

Release Of Care Form

find out more

Release Letter Form

find out more

Protected Health Information Form

find out more

Probate Receipt And Release Form

find out more

Printable Medical Records Release Authorisation Form

find out more

Printable Media Release Form

find out more

Printable Dental Release Form

find out more

Physical Therapy Release Form

find out more

Photo Printing Rights Release Form

find out more

Permission To Use Photo Agreement

find out more

Paid In Full Release Form

find out more

Package Release Form

find out more

Military Medical Records Request Form

find out more

Mental Health Records Release Form

find out more

Medical Treatment Authorisation Form

find out more

Medical Treatment Authorisation And Consent

find out more

Medical Release Form To Return To Work

find out more

Medical Release Form For Family Members

find out more

Medical Release Consent Form

find out more

Medical Consent Authorisation Form

find out more

Licence Release Form

find out more

Legal Release Form

find out more

Letter Of Consent Medical Authorisation Form

find out more

Impound Release Form

find out more

Hospital Release Form

find out more

Hitech Release Form

find out more

Generic Printable Medical Records Release Authorisation Form

find out more

General Release Of Information Consent Form

find out more

General Medical Record Release Form

find out more

General Authorisation To Release Information Form

find out more

Employment Verification Release

find out more

Employer Release Of Information Form

find out more

Emergency Medical Treatment Authorisation Form

find out more

Emergency Medical Authorisation Form

find out more

Driving Record Consent Form

find out more

Dental Release Form

find out more

Dental Records Request Form

find out more

Dental Photo Consent Form

find out more

Dental Patient Release Form

find out more

Dental Medical Records Release Form

find out more

Daycare Medical Release Form

find out more

Consent To Release Personal Information Form

find out more

Consent To Release Medical Records

find out more

Consent For Release Of Protected Health Information

find out more

Client Authorisation To Release Information To Third Parties

find out more

Car Title Lien Release Letter

find out more

Basic Photography Release Form

find out more

Background Release Form

find out more

Authorisation To Use And Disclose Protected Health Information Form

find out more

Authorisation To Release Records

find out more

Authorisation To Release Personal Information

find out more

Authorisation To Release Loan Information

find out more

Authorisation To Release Legal File

find out more

Authorisation To Release Information To Family Members

find out more

Authorisation To Release Information To A Third Party Form

find out more

Authorisation To Release Information

find out more

Authorisation To Release Immunization Records

find out more

Authorisation To Release Health Care Information

find out more

Authorisation To Release Credit Information Form

find out more

Authorisation To Disclose Information

find out more

Authorisation Letter For Release Of Information

find out more

Authorisation For Disclosure Of Information Form

find out more

Authorisation For Disclosure

find out more

Authorisation Disclosure Form

find out more

Authorisation For Release Of Protected Health Information Phi

find out more

Authorisation For Release Of Personal Information

find out more

Authorisation For Release Of Information Form

find out more

Authorisation For Release Of Health Records

find out more

Authorisation For Release Of Health Information

find out more

Authorisation For Release Of Financial Information

find out more

Authorisation For Release Of Employment Records

find out more

Authorisation For Release Of Employment Information

find out more

Authorisation For Release Of Dental Records

find out more

Authorisation For Release Of Confidential Information

find out more

Authorisation For Release Of Cell Phone Records

find out more

Authorisation For Disclosure Of Protected Health Information Form

find out more

Authorisation For Disclosure Of Medical Information

find out more

Actor Release Form

find out more

Authorisation Of Release Of Unemployment Records Form

A legal form used in England and Wales to authorize the release of individual unemployment records in compliance with UK data protection laws.

find out more

Authorisation For Release Of Records

A legal document under English and Welsh law authorizing the release of specific records from one party to another, in compliance with UK data protection legislation.

find out more

Release Of Information Statement

A legal document under English and Welsh law authorizing and governing the release of specific information between parties while ensuring data protection compliance.

find out more

Printable Work Release Form

A legally binding document under English and Welsh law that formalizes the termination of employment and mutual release of claims between employer and employee.

find out more

Dental Release Of Information Form

A legal document under English and Welsh law authorizing the release of dental records and information to specified parties.

find out more

Work Release Form From Doctor

A medical document used in England and Wales certifying an employee's fitness to return to work, compliant with UK healthcare and employment regulations.

find out more

Universal Medical Release Form

A legal document under English and Welsh law authorizing the release of medical records to specified parties while ensuring data protection compliance.

find out more

Service Release Form

A legally binding document under English and Welsh law that releases parties from obligations and liabilities related to completed services.

find out more

Revocation Of Release Of Information Form

An English and Welsh law-compliant document for withdrawing previously granted authorization for information sharing and processing.

find out more

Release Form For Video Recording

A legal document under English and Welsh law that obtains consent for video recording and establishes usage rights for the recorded content.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: /our-research
Oops! Something went wrong while submitting the form.

骋别苍颈别鈥檚 Security Promise

Genie is the safest place to draft. Here鈥檚 how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; 骋别苍颈别鈥檚 AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a 拢1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our for more details and real-time security updates.