The Authorization For Release Of Information Form serves as a crucial legal instrument in Pakistan's information sharing framework. This document is essential when one party needs to formally authorize another party to access or receive their confidential information, whether for medical, financial, educational, or other purposes. The form ensures compliance with Pakistani privacy laws, including the Prevention of Electronic Crimes Act 2016 and constitutional privacy rights under Article 14(1). It is commonly used in various scenarios such as medical record transfers, employment verification, academic record sharing, or financial information disclosure. The document includes specific provisions for information scope, duration of authorization, recipient details, and revocation rights, providing a secure and legally sound framework for information sharing while protecting the privacy rights of the information provider.
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1. Information Provider Details: Full identification details of the person/entity whose information is to be released, including name, address, contact information, and any relevant identification numbers
2. Authorized Recipient Details: Complete details of the person/entity authorized to receive the information, including name, address, contact information, and relationship to the information provider
3. Scope of Authorization: Specific description of what information is authorized to be released, including relevant dates, categories, and any limitations
4. Purpose of Release: Clear statement of why the information is being released and how it will be used
5. Duration of Authorization: Specific timeframe for which the authorization is valid, including start and end dates
6. Rights and Revocation: Statement of the information provider's rights, including the right to revoke authorization and the process for doing so
7. Signatures and Date: Space for signatures of the information provider, witnesses, and date of signing
1. Special Categories of Information: Additional authorization sections for sensitive information such as medical records, financial information, or educational records
2. Third Party Authorization: Section for cases where a third party is authorized to act on behalf of the information provider (e.g., legal guardian, power of attorney)
3. Re-disclosure Provisions: Section specifying whether and under what conditions the authorized recipient may share the information with other parties
4. Electronic Transmission Authorization: Specific authorization for information to be transmitted electronically, including associated risks and security measures
5. Translation Declaration: For forms provided in multiple languages, a section declaring which language version prevails in case of discrepancies
1. Schedule A - Detailed Information List: Itemized list of specific documents, records, or information to be released
2. Schedule B - Authorized Recipients List: If multiple recipients are authorized, detailed list of all authorized recipients and their access levels
3. Appendix 1 - Identification Documents: Copies or details of identification documents provided by the information provider and recipient
4. Appendix 2 - Supporting Documentation: Any additional documentation supporting the authorization (e.g., power of attorney, court orders)
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Office Administrator
Corporate Secretary
Healthcare Administrator
Financial Services Manager
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