Consent Authorization Form

Consent Authorization Form Template for Netherlands

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Key Requirements PROMPT example:

"I need a Consent Authorization Form for our medical research institute in Amsterdam, compliant with Dutch healthcare regulations and GDPR, to obtain patient consent for processing health data and sharing anonymized results with international research partners starting January 2025."

Document background

The Consent Authorization Form is a crucial document required under Dutch law and GDPR regulations when organizations need to obtain explicit consent for processing personal data. This document is essential when consent is the legal basis for data processing, as specified in Article 6(1)(a) of the GDPR and the Dutch UAVG. It should be used whenever an organization needs to collect, process, or share personal data where other legal bases (such as contractual necessity or legitimate interests) do not apply. The form must be written in clear, plain language and include specific information about the processing activities, the data subject's rights, and the ability to withdraw consent. It's particularly important in scenarios involving sensitive data, marketing communications, or when data will be shared with third parties. The document should be maintained as part of the organization's data protection documentation and updated when processing purposes change.

Suggested Sections

1. Identity of Parties: Clearly identifies the data controller (organization requesting consent) and the data subject (individual giving consent), including relevant contact details

2. Purpose of Authorization: Clear explanation of why consent is being requested and how the information/authorization will be used

3. Scope of Consent: Detailed description of exactly what the individual is consenting to, including specific activities and types of data involved

4. Duration of Consent: Specifies how long the consent will remain valid and under what circumstances it might expire

5. Rights of the Data Subject: Explanation of individual's rights under GDPR, including right to withdraw consent, right to access data, and right to be forgotten

6. Data Processing Information: Details about how the data will be processed, stored, and protected

7. Declaration and Signature: Formal declaration of consent and space for signature, date, and any witness requirements

Optional Sections

1. International Data Transfers: Required when data may be transferred outside the EU/EEA, detailing the safeguards in place

2. Special Categories of Data: Required when processing sensitive personal data (health, religious beliefs, etc.), including additional safeguards

3. Third Party Access: Include when other parties may have access to the data, detailing who they are and why they need access

4. Marketing Preferences: Include when consent includes marketing communications, with specific opt-in choices for different channels

5. Parental/Guardian Consent: Required when the data subject is a minor or lacks legal capacity

Suggested Schedules

1. Privacy Notice: Detailed privacy information as required under GDPR Article 13/14, including data retention periods and security measures

2. List of Processing Activities: Detailed breakdown of specific data processing activities covered by the consent

3. Third Party Recipients: List of third parties who may receive or process the data, including their roles and responsibilities

4. Technical and Security Measures: Description of security measures in place to protect the data (particularly relevant for sensitive data)

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

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