The Standard Release of Information Form is a critical document used in New Zealand to facilitate lawful and controlled sharing of personal information between authorized parties. This document becomes necessary when an individual's personal information needs to be transferred from one organization to another, requiring explicit consent under the Privacy Act 2020. The form serves as a formal record of authorization, protecting both the information provider and recipient by clearly documenting the scope and conditions of the information release. It is designed to meet the requirements of New Zealand privacy legislation, including specific provisions for sensitive information such as health records under the Health Information Privacy Code. The form includes comprehensive details about the information being released, the parties involved, the purpose of the release, and the duration of the authorization, ensuring transparency and compliance with privacy principles.
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1. Personal Details: Individual's identification information including full name, date of birth, contact details, and any relevant ID numbers
2. Information Provider Details: Details of the organization/entity holding the information, including name, contact information, and relevant department
3. Information Recipient Details: Details of the person(s) or organization(s) to whom the information will be released
4. Information to be Released: Specific description of the information to be released, including type, date range, and format
5. Purpose of Release: Clear statement of why the information is being released and how it will be used
6. Duration of Authorization: Timeframe for which the authorization is valid, including start and end dates
7. Privacy Rights Statement: Statement of individual's rights under the Privacy Act 2020 and relevant legislation
8. Authorization Declaration: Formal declaration of consent with space for signature, date, and witness details if required
1. Specific Health Information Consent: Additional section when releasing health-related information, incorporating Health Information Privacy Code requirements
2. Third Party Authorization: Used when someone other than the subject is authorized to consent to information release
3. Sensitive Information Details: Special conditions and considerations for release of sensitive personal information
4. Digital Communication Consent: Specific authorization for information to be shared via electronic means
5. Research Use Authorization: Additional consent for information to be used in research purposes
1. Schedule A - Types of Information: Detailed checklist of specific information types authorized for release
2. Schedule B - Authorized Recipients List: Complete list of all authorized recipients when multiple parties are involved
3. Appendix 1 - Privacy Act Rights: Detailed explanation of rights under the Privacy Act 2020
4. Appendix 2 - Glossary: Definitions of technical terms and legal terminology used in the form
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Education
Financial Services
Government Services
Legal Services
Insurance
Social Services
Research Institutions
Employment Services
Professional Services
Relevant Teams
Legal
Compliance
Human Resources
Information Security
Records Management
Risk Management
Operations
Administrative Services
Client Services
Data Protection
Relevant Roles
Privacy Officer
Compliance Manager
Legal Counsel
Records Manager
Information Security Officer
Data Protection Officer
Human Resources Manager
Medical Records Administrator
Client Services Manager
Risk Management Officer
Operations Manager
Administrative Coordinator
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