The Simple Consent Form serves as a fundamental legal document used across various sectors in the Netherlands to obtain and document explicit consent from individuals. This document type is essential for compliance with the Dutch Civil Code, GDPR, and the Dutch GDPR Implementation Act (UAVG). The Simple Consent Form is particularly crucial when organizations need to document informed consent for data processing, medical procedures, research participation, or service provision. It includes mandatory elements required by Dutch law, such as clear purpose specification, explicit consent declarations, and information about the right to withdraw consent. The document's structure ensures transparency and comprehensibility while maintaining legal validity in the Dutch jurisdiction.
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1. Title and Date: Clear identification of the document as a consent form and the date of execution
2. Parties: Identification of the organization requesting consent and the individual providing consent, including full names and relevant contact details
3. Purpose Statement: Clear explanation of what the consent is being requested for, written in plain, understandable language
4. Rights and Information: Description of the individual's rights, including the right to withdraw consent and how to exercise this right
5. Duration: Period for which the consent will remain valid
6. Declaration of Consent: Explicit statement of consent with signature block and date
7. Contact Information: Details of who to contact for questions or to exercise rights under the consent
1. Data Processing Information: Required when consent involves personal data processing, detailing what data will be collected and how it will be used
2. Third Party Sharing: Include when personal data will be shared with third parties, listing recipients or categories of recipients
3. Medical Procedure Details: Required for medical consent forms, describing procedures, risks, and alternatives
4. Research Participation Details: Include for research-related consent, describing the study, methodology, and participant involvement
5. Financial Implications: Include when the consent involves any costs or compensation
6. Withdrawal Consequences: Required when withdrawal of consent may have specific implications or limitations
1. Privacy Notice: Detailed information about data processing activities and privacy practices
2. Procedure Description: Detailed technical or medical information about procedures or processes being consented to
3. Risk Assessment: Comprehensive list of potential risks and mitigation measures
4. Contact List: Extended list of relevant contacts and their roles
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