Employee Medical Release Form

Employee Medical Release Form Template for New Zealand

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Key Requirements PROMPT example:

"I need an Employee Medical Release Form for our construction company that specifically covers workplace injury monitoring and return-to-work assessments, with additional provisions for sharing information with our occupational health provider."

What is a Employee Medical Release Form?

The Employee Medical Release Form is a critical document used in New Zealand workplaces to facilitate the appropriate sharing of employee medical information while ensuring compliance with privacy and employment legislation. This form becomes necessary when employers need access to employee medical information for various legitimate purposes, such as managing workplace accommodations, ensuring workplace safety, or administering leave entitlements. The document must comply with the Privacy Act 2020, Health Information Privacy Code 2020, and other relevant New Zealand legislation. It typically includes specific authorizations, limitations on information use, and clear statements about the employee's rights regarding their medical information. The form serves as a protective measure for both employers and employees by clearly documenting consent and establishing boundaries for information sharing.

What sections should be included in a Employee Medical Release Form?

1. Employee Information: Essential identification details of the employee including full name, date of birth, employee ID, and contact information

2. Purpose of Release: Clear statement of why medical information is being requested and how it will be used by the employer

3. Scope of Authorization: Specific details about what medical information is being authorized for release

4. Duration of Authorization: Time period for which the authorization remains valid

5. Healthcare Provider Authorization: Authorization for specific healthcare providers to release information to the employer

6. Privacy Statement: Statement about how the information will be protected, stored, and handled in compliance with the Privacy Act 2020

7. Employee Rights: Clear outline of the employee's rights regarding their medical information, including right to revoke authorization

8. Signature Block: Space for employee signature, date, and witness signature if required

What sections are optional to include in a Employee Medical Release Form?

1. Specific Medical Condition Details: Used when the release is for a specific medical condition rather than general medical information

2. Emergency Contact Authorization: Optional section authorizing release of information to emergency contacts

3. Third Party Disclosure Authorization: Used when medical information may need to be shared with third parties such as insurance providers or occupational health providers

4. Return to Work Authorization: Specific section for cases involving return to work after medical leave

5. Workplace Accommodation Requirements: Section for specifying any workplace accommodations needed based on medical condition

What schedules should be included in a Employee Medical Release Form?

1. Schedule A - Authorized Healthcare Providers: List of specific healthcare providers authorized to release information

2. Schedule B - Specific Medical Information Checklist: Detailed checklist of specific medical information that is authorized for release

3. Appendix 1 - Privacy Policy Extract: Relevant excerpts from the company's privacy policy regarding medical information handling

4. Appendix 2 - Employee Rights Summary: Detailed summary of employee rights regarding their medical information under NZ law

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

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Manufacturing

Construction

Mining

Agriculture

Transportation

Education

Professional Services

Retail

Hospitality

Technology

Public Sector

Energy

Maritime

Aviation

Relevant Teams

Human Resources

Health and Safety

People Operations

Legal

Compliance

Risk Management

Employee Relations

Occupational Health

Benefits Administration

Relevant Roles

Human Resources Manager

Health and Safety Manager

HR Director

Occupational Health Nurse

HR Business Partner

Employee Relations Manager

Workplace Health Coordinator

Risk Management Officer

HR Administrator

Compliance Manager

Personnel Manager

Benefits Administrator

HR Operations Manager

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Let's create your Employee Medical Release Form

What is a Employee Medical Release Form?

What sections should be included in a Employee Medical Release Form?

What sections are optional to include in a Employee Medical Release Form?

What schedules should be included in a Employee Medical Release Form?

Authors

Alex Denne

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