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The Authorization For Release Of Medical Information is a crucial document used in the Netherlands when medical information needs to be shared between healthcare providers, institutions, or other authorized parties. This document is essential for maintaining compliance with the EU General Data Protection Regulation (GDPR), the Dutch GDPR Implementation Act (UAVG), and the Medical Treatment Contracts Act (WGBO). It is typically required when patients change healthcare providers, seek specialist treatment, apply for insurance, or participate in medical research. The authorization ensures transparent and lawful processing of medical data while protecting patient privacy rights and maintaining professional medical standards under Dutch law.

1. Parties: Identifies the patient (data subject) and the healthcare provider/institution currently holding the medical information

2. Background: Brief context explaining why the authorization is being created

3. Definitions: Defines key terms used in the authorization, including types of medical information, parties involved, and technical terms

4. Scope of Authorization: Specifies exactly what medical information is authorized for release, including date ranges and types of records

5. Recipient Information: Details of who is authorized to receive the medical information, including name, role, and organization

6. Purpose of Disclosure: Clearly states the specific purpose(s) for which the medical information may be used

7. Duration of Authorization: Specifies how long the authorization remains valid and its expiration date

8. Rights and Revocation: Explains the patient's rights, including the right to revoke authorization and how to do so

9. Data Protection Provisions: Specifies how the released information must be handled in compliance with GDPR and Dutch privacy laws

10. Execution: Space for signatures, dates, and witness information if required