Authorization To Share Information

Authorization To Share Information Template for Belgium

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Key Requirements PROMPT example:

"I need an Authorization to Share Information document for a Belgian medical practice, allowing my healthcare records to be shared between my primary physician and three specialist consultants for a period of six months starting March 1, 2025."

Document background

The Authorization To Share Information document is essential in today's data-driven environment where organizations need explicit permission to share personal or confidential information. This document is specifically designed to comply with Belgian law and EU GDPR requirements, making it suitable for use by organizations operating in Belgium or handling data of Belgian residents. It's particularly important when sharing sensitive personal data, medical information, financial records, or other confidential information between parties. The authorization template includes all necessary elements required by Belgian Data Protection Act and GDPR, such as specific consent clauses, data subject rights, and withdrawal procedures. This document should be used whenever there's a need to share information beyond the original purpose of collection or with third parties, ensuring legal compliance and protecting both the data subject's rights and the organization's interests.

Suggested Sections

1. Date and Place: Current date and location where the authorization is being made

2. Authorizing Party Details: Full name, address, and contact information of the person/entity giving authorization to share information

3. Recipient Organization Details: Full name and details of the organization(s) authorized to receive and share the information

4. Purpose of Authorization: Clear statement of the specific purpose(s) for which the information sharing is authorized

5. Information to be Shared: Detailed description of the specific information or categories of information authorized to be shared

6. Duration of Authorization: Specific period for which the authorization remains valid, including start and end dates

7. Rights Statement: Statement of the authorizing party's rights, including right to withdraw consent and data subject rights under GDPR

8. Signature Block: Space for signature, printed name, and date of signing by the authorizing party

Optional Sections

1. Special Categories of Data: Additional section required when sharing sensitive personal data as defined in GDPR Article 9, including explicit consent statement

2. Third Party Recipients: Section needed when information may be shared with additional third parties beyond the primary recipient

3. Cross-border Transfer: Required when information may be transferred outside the EEA, including specific consent for such transfers

4. Representative Authorization: Required when the authorization is being given by someone acting on behalf of the data subject (e.g., parent, guardian, or authorized representative)

5. Revocation Procedure: Detailed procedure for withdrawing consent, included when the authorization process is complex or involves multiple parties

Suggested Schedules

1. Detailed Information List: Itemized list of specific documents or information types covered by the authorization

2. Recipient List: If multiple recipients, detailed list of all authorized recipients with full contact information

3. Privacy Notice: Copy of the relevant privacy notice or data protection information as required by GDPR Article 13/14

4. Processing Activities: Detailed description of how the shared information will be processed, if complex or multiple types of processing involved

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

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Authorization To Share Medical Information Form

A Belgian-compliant authorization form for sharing medical information, meeting GDPR and local healthcare law requirements.

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Authors

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