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Statement Of Consent Template for Netherlands

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Key Requirements PROMPT example:

Statement Of Consent

"I need a Statement of Consent for collecting patient data for a medical research study starting in March 2025, which will involve processing sensitive health information and sharing anonymized results with research partners in Germany."

Document background
The Statement of Consent is a crucial document required under Dutch law whenever organizations need to obtain explicit permission from individuals for processing their personal data. This document is particularly important in the context of the EU General Data Protection Regulation (GDPR) and its Dutch implementation through the UAVG (Uitvoeringswet AVG). The Statement of Consent must be presented in clear, plain language and should specifically detail what data will be collected, how it will be used, who will have access to it, and how long it will be retained. It's essential when processing special categories of personal data, when consent is the legal basis for processing, or when existing consent needs to be updated or renewed. The document must include mechanisms for withdrawing consent and clearly explain the data subject's rights under Dutch and EU law.
Suggested Sections

1. Identity and Contact Details: Full name, contact information, and any relevant identification details of the person giving consent (data subject)

2. Purpose of Consent: Clear and specific description of what the consent is being given for, including the exact purpose and scope of the permitted activities

3. Data Controller Information: Identity and contact details of the organization/entity requesting consent, including their role as data controller

4. Rights Statement: Clear explanation of the data subject's rights, including the right to withdraw consent and how to exercise this right

5. Duration of Consent: Specification of how long the consent will remain valid and any conditions for expiration

6. Declaration: Formal statement confirming that the person has read, understood, and freely agrees to the consent terms

7. Signature Block: Space for signature, date, and place of signing, including options for digital signature if applicable

Optional Sections

1. Third Party Disclosure: Required when personal data will be shared with third parties, listing the recipients or categories of recipients

2. International Transfers: Required when personal data will be transferred outside the EU/EEA, describing the transfer mechanisms and safeguards

3. Special Categories of Data: Required when processing sensitive personal data (health, biometric, etc.), with explicit acknowledgment of the sensitive nature

4. Parental Consent: Required when the data subject is under 16 years old, including parent/guardian details and signature

5. Processing Methods: Optional section detailing specific methods of data processing when relevant to the consent decision

6. Language Declaration: Required when the consent form is provided in multiple languages, specifying which version is controlling

Suggested Schedules

1. Privacy Notice: Detailed privacy information providing additional context for the consent, including data protection practices

2. Data Processing Activities: Detailed list of specific data processing activities covered by the consent

3. Contact Procedures: Detailed procedures for exercising rights or withdrawing consent, including relevant forms and contact points

4. Third Party List: If applicable, detailed list of third parties who will have access to the data, including their roles and responsibilities

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

Healthcare

Financial Services

Education

Technology

Telecommunications

Human Resources

Research & Development

Marketing

E-commerce

Insurance

Professional Services

Public Sector

Non-profit Organizations

Pharmaceuticals

Clinical Research

Relevant Teams

Legal

Compliance

Data Protection

Human Resources

Information Security

Risk Management

Customer Relations

Marketing

Research

Clinical Operations

Quality Assurance

Information Technology

Operations

Privacy

Project Management

Relevant Roles

Data Protection Officer

Privacy Officer

Compliance Manager

Legal Counsel

HR Manager

Information Security Officer

Risk Manager

Operations Manager

Project Manager

Research Coordinator

Marketing Manager

Customer Service Manager

Clinical Trial Coordinator

IT Security Manager

Quality Assurance Manager

Industries







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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