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The Dental Records Release Form is a crucial document used in Maltese dental practices to facilitate the legal and compliant transfer of patient dental records. This form becomes necessary when patients require their records to be shared with other healthcare providers, insurance companies, or authorized third parties. It ensures compliance with both the EU General Data Protection Regulation (GDPR) and Maltese healthcare regulations, including the Health Act and Data Protection Act. The form captures essential information including patient details, specific records to be released, recipient information, and explicit consent for the transfer. It serves as a legal record of authorization while protecting patient privacy rights and maintaining professional dental practice standards in Malta.

1. Patient Information: Full legal name, date of birth, contact details, and patient identification number of the person whose records are being released

2. Requesting Party Details: Information about who is requesting the records (patient themselves, legal guardian, other healthcare provider, or authorized third party)

3. Records Description: Specific description of which dental records are being requested (e.g., x-rays, treatment history, billing records, specific date ranges)

4. Purpose of Release: Statement of the intended use of the released records

5. Release Authorization: Express consent statement and GDPR-compliant authorization for release of records

6. Duration of Authorization: Timeframe for which this release authorization is valid

7. Recipient Information: Details of where and to whom the records should be sent

8. Signature Block: Space for patient/guardian signature, date, and witness signature if required