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Personal Information Release Form Template for England and Wales

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Key Requirements PROMPT example:

Personal Information Release Form

"I need a Personal Information Release Form to authorize the transfer of my medical records from London General Hospital to a specialist clinic in Manchester, with the authorization period running from March 1, 2025 to September 30, 2025, including specific provisions for sharing diagnostic images and test results."

Document background
The Personal Information Release Form serves as a critical tool for organizations and individuals needing to share personal information in compliance with UK data protection laws. This document is essential when personal data needs to be transferred between parties while maintaining legal compliance and protecting individual privacy rights. It's particularly relevant under the UK GDPR and Data Protection Act 2018 framework, which requires explicit consent for data processing and transfer. The form typically includes detailed specifications about the information being shared, the purpose of sharing, recipient details, and duration of authorization, making it suitable for use across various sectors where personal data handling is required.
Suggested Sections

1. Information About the Data Subject: Personal details of individual whose information is being released

2. Information to be Released: Specific description of what personal information is authorized for release

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

4. Recipient Details: Information about who will receive the personal information

5. Duration of Authorization: Time period for which the release authorization is valid

6. Declaration and Signature: Formal consent statement and signature block

Optional Sections

1. Third Party Authorization: Additional section required when someone other than the data subject is authorizing release (e.g., for minors, individuals lacking capacity, or authorized representatives)

2. Special Category Data: Additional provisions required when releasing health, biometric, genetic, or other sensitive data

3. Withdrawal of Consent: Section detailing the process for revoking authorization

Suggested Schedules

1. Schedule 1: Detailed Information List: Itemized list of specific information to be released

2. Schedule 2: Proof of Identity: Requirements for identity verification

3. Appendix A: Privacy Notice: Detailed information about how the data will be processed and protected

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
























Clauses
























Relevant Industries
Relevant Teams
Relevant Roles
Industries

UK General Data Protection Regulation (UK GDPR): Primary data protection legislation covering principles of data processing, lawful bases for processing, individual rights, and requirements for valid consent

Data Protection Act 2018: UK's implementation of GDPR including specific provisions for UK context, special category data requirements, and criminal record data handling

Privacy and Electronic Communications Regulations 2003 (PECR): Regulations governing electronic communications and requirements for electronic marketing consent

Common Law Duty of Confidentiality: Legal principle protecting confidential information and establishing requirements for valid consent to share confidential information

Human Rights Act 1998: Legislation incorporating Article 8 (right to privacy) and the balance of privacy rights with other interests

Freedom of Information Act 2000: Legislation governing information disclosure obligations for public bodies and its interaction with privacy rights

Mental Capacity Act 2005: Legislation relevant to determining an individual's capacity to provide valid consent for information sharing

Children Act 1989: Legislation governing the handling of information relating to minors and their rights

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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