Medical Release Form

Medical Release Form Template for Austria

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Key Requirements PROMPT example:

"I need a Medical Release Form for my private medical practice in Vienna, compliant with Austrian law and GDPR, that allows for the release of patient records to both local hospitals and insurance providers, with an emphasis on electronic record transfer."

Document background

The Medical Release Form is a crucial document in Austrian healthcare settings, required whenever patient medical information needs to be shared between healthcare providers or released to authorized parties. This document ensures compliance with Austrian medical privacy laws, including the Ärztegesetz and Krankenanstaltengesetz, as well as EU GDPR requirements. The form is essential for maintaining patient privacy while facilitating necessary medical information transfer between healthcare providers, insurance companies, or other authorized recipients. It must be used when sharing any patient medical records, test results, treatment histories, or other protected health information. The document includes specific provisions for patient identification, detailed scope of information to be released, duration of authorization, and clear statements of patient rights under Austrian law.

Suggested Sections

1. Patient Information: Complete identification details of the patient including full name, date of birth, address, insurance number, and contact information

2. Healthcare Provider Information: Details of the healthcare provider/facility requesting the release, including name, address, and registration numbers

3. Scope of Release: Specific description of medical information to be released, including time period covered and types of records

4. Purpose of Disclosure: Clear statement of the reason for releasing medical information

5. Authorization Statement: Formal declaration of consent for release of medical information, including acknowledgment of understanding

6. Duration of Authorization: Specification of how long the authorization remains valid

7. Rights and Notices: Statement of patient rights including right to revoke authorization and receive copies

8. Signatures: Spaces for patient signature, date, and witness signature if required

Optional Sections

1. Special Categories of Information: Additional authorization for sensitive information such as mental health records, HIV status, or genetic information

2. Minor/Guardian Authorization: Required when the patient is a minor or has a legal guardian

3. Electronic Communication Consent: Optional authorization for transmission of medical information via electronic means

4. Research Authorization: Additional consent for use of medical information in research studies

5. Language Assistance: Confirmation of translation or interpretation services if the patient's primary language is not German

Suggested Schedules

1. Detailed Record List: Itemized list of specific medical records to be released

2. Privacy Notice: Detailed information about privacy rights and data protection under Austrian law and GDPR

3. Authorized Recipients: List of specific individuals or organizations authorized to receive the medical information

4. Revocation Form: Template form for future revocation of the authorization 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 | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Medical Services

Hospital Administration

Insurance

Pharmaceuticals

Medical Research

Elder Care

Mental Health Services

Rehabilitation Services

Public Health

Relevant Teams

Legal

Compliance

Medical Records

Patient Administration

Risk Management

Data Protection

Quality Assurance

Patient Services

Medical Administration

Insurance Coordination

Relevant Roles

Medical Doctor

Hospital Administrator

Clinic Manager

Medical Records Officer

Healthcare Compliance Officer

Legal Counsel

Privacy Officer

Insurance Claims Manager

Medical Secretary

Practice Manager

Healthcare Risk Manager

Data Protection Officer

Patient Relations Coordinator

Medical Research Coordinator

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