Release Of Information Request Form

Release Of Information Request Form Template for Nigeria

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Key Requirements PROMPT example:

"I need a Release of Information Request Form for a multi-specialty medical clinic in Lagos, which allows patients to authorize the release of their medical records to multiple healthcare providers and insurance companies, with the form validity period extending through March 2025."

Document background

The Release of Information Request Form is a critical document used in Nigeria when an individual or organization needs to formally request access to personal or confidential information held by another party. This document has become increasingly important since the implementation of the Nigeria Data Protection Regulation (NDPR) 2019, which establishes strict requirements for data protection and information sharing. The form serves as both a request mechanism and a record of authorization, protecting the rights of the information subject while providing necessary documentation for the information holder. It is designed to capture all essential elements required by Nigerian law, including clear purpose specification, consent documentation, and data protection commitments. This document is particularly relevant in healthcare, financial services, and other sectors where personal data processing is common, and must be handled in accordance with Nigerian privacy laws and regulations.

Suggested Sections

1. Form Title and Reference Number: Clear identification of the document as a Release of Information Request Form with a unique reference number

2. Requestor Information: Details of the person/organization requesting the information, including full name, contact details, and relationship to the subject

3. Subject Information: Details of the person whose information is being requested, including full name, date of birth, and contact information

4. Information Requested: Specific description of the information being requested, including relevant dates and types of records

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

6. Authorization Statement: Formal declaration authorizing the release of information, including validity period

7. Data Protection Notice: Statement explaining how the requested information will be protected and handled in accordance with NDPR 2019

8. Signature Block: Space for signatures of the subject (or authorized representative) and date

Optional Sections

1. Witness Section: Required when the subject cannot sign or when additional verification is needed

2. Legal Representative Authorization: Used when someone other than the subject is authorizing the release

3. Emergency Contact Information: Optional section for providing emergency contact details

4. Fee Declaration: Required when there are costs associated with processing the information request

5. Special Instructions: Section for any specific handling or delivery instructions for the requested information

Suggested Schedules

1. Types of Information Checklist: Detailed checklist of different types of information that can be requested

2. Acceptable ID Documents: List of acceptable identification documents required for verification

3. Fee Schedule: If applicable, breakdown of potential fees for different types of information requests

4. Third Party Authorization Form: Additional form required when information is to be released to a third party

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

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Financial Services

Education

Government/Public Sector

Insurance

Legal Services

Human Resources

Banking

Telecommunications

Social Services

Relevant Teams

Legal

Compliance

Data Protection

Information Security

Human Resources

Medical Records

Customer Service

Operations

Risk Management

Administrative Services

Relevant Roles

Data Protection Officer

Compliance Manager

Legal Counsel

Privacy Officer

Records Manager

Information Security Officer

HR Manager

Medical Records Officer

Compliance Coordinator

Risk Manager

Administrative Officer

Customer Service Manager

Operations Manager

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Info Release Form

A Nigerian law-compliant document authorizing the controlled release of information between parties, incorporating NDPR requirements and data protection principles.

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Let's create your Release Of Information Request Form

Authors

Alex Denne

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