The Consent To Release Medical Information document is essential in Nigerian healthcare settings where patient information needs to be shared between healthcare providers, insurance companies, or other authorized parties. This document is required whenever protected health information needs to be disclosed to third parties, ensuring compliance with the National Health Act 2014 and NDPR 2019. It specifies the scope of information to be released, the purpose of disclosure, and the duration of authorization, while protecting patient privacy rights. The document is particularly important given Nigeria's increasing focus on healthcare data protection and patient privacy rights, and it helps healthcare providers maintain legal compliance while facilitating necessary information sharing.
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1. Parties: Identifies the patient (information owner), the releasing healthcare provider/facility, and the recipient of the medical information
2. Background: Brief context explaining the purpose of the document and its legal basis under Nigerian law
3. Definitions: Defines key terms used in the document including 'medical information', 'healthcare provider', 'authorized recipient'
4. Information to be Released: Specific description of medical information authorized for release, including date ranges and types of records
5. Purpose of Disclosure: Clear statement of the purpose for which the medical information is being released
6. Duration of Consent: Specifies how long the authorization remains valid
7. Rights of the Patient: Outlines the patient's rights including the right to revoke consent and receive copies of released records
8. Signatures and Declaration: Space for patient's signature, date, and witness signatures if required
1. Special Categories of Information: Additional authorization for sensitive information like HIV status, mental health records, or genetic information - include when such specific records are involved
2. Electronic Transfer Provisions: Specific provisions for electronic transfer of records - include when digital transmission is anticipated
3. Third Party Authorization: Authorization for a third party to act on behalf of the patient - include when someone other than the patient is authorizing release
4. International Transfer Provisions: Additional provisions for international transfer of medical information - include when records will be sent outside Nigeria
1. Schedule A - Detailed Record List: Itemized list of specific medical records to be released, including dates and record types
2. Schedule B - Authorized Recipients: List of all authorized recipients and their contact details when multiple recipients are involved
3. Appendix 1 - Patient Rights Summary: Detailed explanation of patient rights regarding medical information under Nigerian law
4. Appendix 2 - Privacy Notice: Summary of how the medical information will be handled and protected by the recipient
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Insurance
Legal Services
Medical Research
Pharmaceuticals
Education (Medical Institutions)
Government Health Services
Healthcare Technology
Occupational Health
Relevant Teams
Legal
Compliance
Medical Records
Patient Services
Operations
Quality Assurance
Data Protection
Administrative Services
Clinical Operations
Risk Management
Relevant Roles
Medical Director
Hospital Administrator
Compliance Officer
Medical Records Manager
Healthcare Privacy Officer
Legal Counsel
Clinical Director
Insurance Claims Processor
Research Coordinator
Medical Secretary
Data Protection Officer
Healthcare Operations Manager
Patient Services Coordinator
Quality Assurance Manager
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