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Medical Records Transfer Form for United Arab Emirates

Medical Records Transfer Form Template for United Arab Emirates

A comprehensive legal document designed for use in the United Arab Emirates healthcare system that facilitates the authorized transfer of medical records between healthcare providers while ensuring compliance with UAE Federal Law No. 2 of 2019 and other relevant healthcare data protection regulations. The form encompasses patient identification, detailed record specifications, authorization mechanisms, and transfer protocols, incorporating necessary safeguards for patient privacy and data security as required by UAE healthcare authorities.

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Medical Records Transfer Form

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What is a Medical Records Transfer Form?

The Medical Records Transfer Form is a crucial document used in the United Arab Emirates healthcare system to facilitate the legal and secure transfer of patient medical records between healthcare providers. This document is essential when patients change healthcare providers, seek second opinions, or require their medical information to be shared for continued care. The form must comply with UAE Federal Law No. 2 of 2019 regarding health data protection, as well as other relevant healthcare regulations. It includes comprehensive sections for patient identification, detailed specification of requested records, authorization protocols, and transfer methods. The document is designed to protect patient privacy while ensuring efficient access to necessary medical information for healthcare continuity.

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

1. Patient Information: Essential demographic details including full name (as per Emirates ID), Emirates ID number, date of birth, contact information, and medical record number

2. Requesting Facility/Provider Information: Details of the healthcare provider/facility requesting the records, including license numbers and contact information

3. Releasing Facility/Provider Information: Information about the current healthcare provider/facility releasing the records, including license numbers and contact information

4. Records Requested: Specific details of the medical records being requested, including date ranges and types of records

5. Purpose of Transfer: Clear statement of the reason for the medical records transfer request

6. Patient Authorization: Formal authorization section with patient (or legal guardian) signature, including acknowledgment of understanding and consent for transfer

7. Verification of Identity: Confirmation of patient identity verification process as per UAE regulations

8. Transfer Method: Specification of how the records will be transferred (electronic/physical) and security measures in place

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

1. Urgent Request Designation: Additional section for cases requiring expedited processing, including justification for urgency

2. Third Party Authorization: Used when someone other than the patient is authorized to request/receive records

3. International Transfer Details: Required when records are being transferred outside the UAE, including additional compliance requirements

4. Translation Requirements: Section specifying if documents need to be translated and authenticated, particularly for international transfers

5. Special Records Designation: For sensitive medical information requiring additional authorization (e.g., psychiatric records, genetic testing)

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

1. Schedule A: Types of Medical Records: Detailed checklist of all possible types of medical records that can be transferred

2. Schedule B: Fee Schedule: List of applicable fees for different types of record transfers and processing times

3. Schedule C: Identity Verification Documents: List of acceptable identification documents as per UAE regulations

4. Appendix 1: Privacy Notice: Detailed information about how the transferred medical records will be handled and protected

5. Appendix 2: Patient Rights: Summary of patient rights regarding their medical records under UAE law

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Cost

Free to use
Relevant legal definitions

























Clauses




















Relevant Industries

Healthcare

Medical Services

Hospital Administration

Clinical Practice

Healthcare Technology

Medical Records Management

Data Protection

Healthcare Compliance

Private Healthcare

Public Healthcare

Relevant Teams

Medical Records

Compliance

Legal

Patient Services

Healthcare Information Management

Quality Assurance

Clinical Operations

Data Protection

Administrative Services

Document Management

Relevant Roles

Medical Records Officer

Healthcare Administrator

Compliance Officer

Medical Director

Clinical Operations Manager

Data Protection Officer

Healthcare Facility Manager

Patient Services Coordinator

Medical Records Technician

Healthcare Information Manager

Quality Assurance Manager

Privacy Officer

Medical Secretary

Healthcare Documentation Specialist

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, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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