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1. Specific Exclusions: Section to explicitly state any medical information that should NOT be released - used when patient wants to restrict certain sensitive information

2. Representative Authority: Additional section required when someone other than the patient is authorizing the release, including proof of authority (e.g., power of attorney, legal guardian)

3. Special Authorizations: Separate authorization sections for sensitive information such as mental health records, HIV status, or genetic information - used when such specific information needs to be released

4. Electronic Transfer Authorization: Additional authorization for electronic transfer of records - used when records will be transmitted electronically

5. Fee Acknowledgment: Section acknowledging any fees associated with the release of records - used when the healthcare provider charges for record copies

1. Schedule A - Types of Medical Information: Detailed checklist of specific types of medical information that may be released (e.g., consultation notes, test results, imaging reports)

2. Schedule B - Approved Recipients List: List of pre-approved healthcare providers or organizations authorized to receive the information - used when multiple recipients are involved

3. Appendix 1 - Privacy Notice: Detailed privacy notice explaining how the information will be handled and protected, as required by the Privacy Act 1988

4. Appendix 2 - Patient Rights: Detailed explanation of patient rights regarding their medical information and this authorization