The Permission To Release Medical Records document is a crucial legal instrument in Hong Kong's healthcare system, designed to facilitate the authorized sharing of medical information while maintaining compliance with the Personal Data (Privacy) Ordinance and healthcare regulations. This document becomes necessary when medical records need to be transferred between healthcare providers, shared with insurance companies, or disclosed to other authorized parties. It serves as a formal authorization that protects both the patient's privacy rights and the healthcare provider's legal obligations. The document must incorporate specific requirements under Hong Kong law, including detailed patient identification, explicit consent provisions, and clear specification of the information to be released. It is particularly important in cases involving insurance claims, changing healthcare providers, seeking second medical opinions, or participating in medical research.
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1. Patient Information: Full legal name, HKID number, date of birth, contact details, and other identifying information of the patient
2. Healthcare Provider Information: Details of the healthcare provider/facility currently holding the medical records, including name, address, and contact information
3. Recipient Information: Details of the person or entity to whom the medical records will be released, including name, address, and contact information
4. Records to be Released: Specific description of medical records to be released, including type of records, date ranges, and any specific exclusions
5. Purpose of Disclosure: Clear statement of the purpose for which the medical records are being released
6. Duration of Authorization: Specification of how long the authorization remains valid
7. Rights and Revocation: Statement of patient's rights and procedure for revoking the authorization
8. Signatures and Date: Space for patient (or authorized representative) signature, witness signature if required, and date
1. Legal Representative Authorization: Additional section required when someone other than the patient is authorizing the release, including proof of legal authority
2. Sensitive Information Authorization: Specific authorization for release of sensitive information such as mental health records, HIV status, or substance abuse treatment
3. Electronic Transfer Consent: Additional consent for electronic transfer of records, if applicable
4. Translation Certificate: Required when the form is provided in multiple languages or when the patient's primary language is not English or Chinese
5. Fee Schedule: If applicable, details of any fees associated with the release of records
1. Schedule A - Detailed Record List: Itemized list of specific medical records to be released, including dates and types of records
2. Schedule B - Authorized Recipients: List of all authorized recipients if multiple parties are to receive the records
3. Appendix 1 - Identity Verification Requirements: Documentation requirements for verifying the identity of the patient or authorized representative
4. Appendix 2 - Privacy Notice: Detailed privacy notice explaining how the released information will be protected and used in accordance with Hong Kong privacy laws
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