Medical Records Consent Form - United Arab Emirates

Medical Records Consent Form Template for United Arab Emirates

A comprehensive consent form designed for use in the United Arab Emirates healthcare system, complying with Federal Law No. 2 of 2019 (Health Data Law) and other relevant UAE healthcare regulations. This document establishes legal authorization for healthcare providers to collect, use, and share patient medical records while ensuring patient privacy rights are protected. It includes provisions for both electronic and physical records management, specific authorizations for different types of medical information, and mandatory bilingual requirements (Arabic and English) as per UAE law.

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What is a Medical Records Consent Form?

The Medical Records Consent Form is a crucial document required by UAE healthcare facilities to comply with Federal Law No. 2 of 2019 and related healthcare regulations. This form must be obtained before collecting, using, or sharing patient medical information, except in emergency situations as defined by law. It establishes the scope of consent, specifies authorized recipients, and outlines the duration of authorization. The document must be provided in both Arabic and English, and includes provisions for both physical and electronic records. Healthcare providers must ensure this form is completed and properly documented to maintain compliance with UAE health authority requirements and protect patient privacy rights while facilitating necessary medical information sharing.

What sections should be included in a Medical Records Consent Form?

1. Patient Information: Complete identification details of the patient including name, Emirates ID, date of birth, contact information, and medical record number

2. Healthcare Provider Details: Information about the healthcare facility, including name, license number, and contact details

3. Purpose of Consent: Clear explanation of why the consent is being sought and how the medical records will be used

4. Scope of Authorization: Detailed description of what medical information is covered by this consent, including time periods and types of records

5. Authorized Recipients: Identification of individuals or entities authorized to receive the medical records

6. Duration of Consent: Specification of how long the consent remains valid

7. Patient Rights: Statement of patient's rights regarding their medical records, including right to revoke consent

8. Confidentiality Statement: Declaration of how confidentiality will be maintained and information protected

9. Signatures: Space for patient (or legal representative) signature, date, and witness signature if required

What sections are optional to include in a Medical Records Consent Form?

1. Legal Representative Authorization: Additional section when consent is given by a legal representative rather than the patient directly

2. Specific Exclusions: Section to specify any particular records or information that should be excluded from the consent

3. Electronic Records Access: Additional provisions for electronic access to medical records if applicable

4. International Transfer Consent: Required when medical records may be transferred outside the UAE

5. Research Use Authorization: Optional section for consent to use records in medical research

6. Emergency Contact Information: Additional contact details for emergency situations

7. Insurance Information: Section for insurance details if relevant to the purpose of record sharing

What schedules should be included in a Medical Records Consent Form?

1. Types of Medical Records Covered: Detailed list of all types of medical records included in the consent (e.g., lab results, imaging, prescriptions)

2. Authorized Recipients List: Detailed list of all authorized recipients with their contact information and roles

3. Patient Rights Summary: Comprehensive explanation of patient rights under UAE law regarding medical records

4. Arabic Translation: Required Arabic version of the consent form as per UAE law

5. Revocation Form: Template form for future revocation of consent if needed

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents

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Download a Standard Medical Records Consent Form

Review your own Medical Records Consent Form

What is a Medical Records Consent Form?

What sections should be included in a Medical Records Consent Form?

What sections are optional to include in a Medical Records Consent Form?

What schedules should be included in a Medical Records Consent Form?

Authors

Alex Denne

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