Consent Release Form

Consent Release Form Template for Belgium

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Key Requirements PROMPT example:

"I need a Consent Release Form for my medical research institute in Belgium to collect and process patient health data for a clinical trial starting in March 2025, including provisions for sharing anonymized data with research partners in the EU."

Document background

The Consent Release Form is a crucial document used in Belgium to obtain explicit consent for personal data processing activities, as required by both the GDPR and Belgian Privacy Act. This document is essential when organizations need to collect, process, or share personal data, requiring clear documentation of informed consent. The form must be provided in the appropriate official language (Dutch, French, or German) depending on the region within Belgium. It includes mandatory information about the purpose of data processing, data subject rights, and withdrawal procedures. The Consent Release Form serves as evidence of compliance with Article 7 of the GDPR and corresponding Belgian privacy laws, providing protection for both the data controller and the data subject.

Suggested Sections

1. Identification of Parties: Details of the data controller/organization requesting consent and the data subject/individual giving consent

2. Purpose of Consent: Clear and specific description of what the consent is being given for

3. Nature of Personal Data: Specific description of what personal data will be collected, processed, or shared

4. Duration and Scope: Time period for which the consent is valid and geographical/jurisdictional scope

5. Rights of the Data Subject: Explanation of rights under GDPR including right to withdraw consent, access data, request deletion

6. Processing Activities: Detailed description of how the personal data will be used, processed, or shared

7. Security Measures: Overview of measures taken to protect the personal data

8. Withdrawal Procedure: Clear explanation of how to withdraw consent and the consequences of withdrawal

9. Declaration and Signature: Formal declaration of consent and space for signature(s) and date

Optional Sections

1. Parental Consent: Additional section required when the data subject is a minor

2. Special Categories of Data: Additional provisions when processing sensitive data (health, biometric, etc.)

3. International Transfers: Required when personal data will be transferred outside the EU/EEA

4. Commercial Usage: Additional terms when personal data will be used for commercial purposes

5. Media Release: Specific provisions for use of images, videos, or other media

6. Research Purposes: Additional terms when data is collected for research purposes

7. Third Party Sharing: Detailed information about third parties with whom data will be shared

Suggested Schedules

1. Data Processing Activities: Detailed list of specific data processing activities covered by the consent

2. Privacy Notice: Comprehensive privacy notice as required by GDPR Article 13/14

3. Technical Security Measures: Detailed description of security measures implemented to protect personal data

4. Third Party Recipients: List of third parties who may receive or process the personal data

5. Withdrawal Form: Template form for withdrawing consent

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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