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Consent To Release Medical Records Template for England and Wales

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Key Requirements PROMPT example:

Consent To Release Medical Records

"I need a Consent To Release Medical Records form that allows my GP to share my full medical history with a specialist clinic in London, with the consent valid for 6 months starting from January 2025."

Document background
The Consent To Release Medical Records is a crucial document in healthcare information management under English and Welsh law. It serves as a formal authorization mechanism when medical records need to be shared with third parties, such as other healthcare providers, insurance companies, or legal representatives. The document ensures compliance with UK GDPR, the Data Protection Act 2018, and healthcare regulations while protecting patient privacy. It typically includes patient identification details, specific consent parameters, temporal validity, and clear authorization for the release of specified medical information.
Suggested Sections

1. Patient Information: Full name, date of birth, address, NHS number or other unique identifier

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

3. Scope of Consent: Specific description of what medical records are being released

4. Recipient Information: Details of who is authorized to receive the records

5. Duration of Consent: Time period for which the consent is valid

6. Declaration and Signature: Patient's confirmation and signature, date of signing

Optional Sections

1. Third Party Authorization: When someone other than the patient is authorized to consent

2. Specific Exclusions: When certain parts of the medical record are to be excluded from release

3. Purpose of Release: When the purpose needs to be specified (e.g., insurance, legal proceedings)

4. Capacity Assessment: When there are questions about the patient's capacity to consent

Suggested Schedules

1. List of Specific Records: Detailed inventory of specific records to be released

2. Proof of Identity: Copies of identity documents when required

3. Power of Attorney/Court Order: When consent is given by someone other than the patient

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions

























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Industries

UK General Data Protection Regulation (UK GDPR): Primary legislation governing personal data processing in the UK, requiring explicit consent for processing health data, establishing data processing principles and data subject rights

Data Protection Act 2018: The UK's implementation of data protection law that supplements the UK GDPR and contains specific provisions about handling health data

Access to Health Records Act 1990: Legislation governing access to deceased patients' medical records and the rights of access to such records

Common Law Duty of Confidentiality: Fundamental legal principle requiring healthcare providers to maintain patient confidentiality and obtain consent before sharing confidential information

Mental Capacity Act 2005: Legislation dealing with capacity to consent and determining who can make decisions on behalf of individuals lacking capacity

Health and Social Care Act 2012: Contains specific provisions regarding information governance in healthcare settings and data sharing

Professional Guidelines: Includes guidance from General Medical Council (GMC), NHS, and British Medical Association (BMA) on handling medical records and patient confidentiality

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,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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