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1. Legal Guardian Authorization: Required when the patient is a minor or legally incompetent, including guardian's details and relationship to patient

2. Third Party Access Authorization: Used when specific permission is being granted for other healthcare providers or institutions to access records

3. Research Use Consent: Optional section for patients to authorize use of their medical records in research studies

4. Electronic Records Access: Additional terms for accessing records through electronic platforms or patient portals

5. International Transfer Authorization: Required when medical records may be transferred outside Saudi Arabia

1. Schedule A: Types of Medical Information: Detailed list of categories of medical information covered by the consent

2. Schedule B: Authorized Recipients: List of specific individuals or entities authorized to receive the medical records

3. Appendix 1: Patient Rights Summary: Detailed explanation of patient rights regarding medical records under Saudi law

4. Appendix 2: Privacy Policy: Detailed privacy policy and data protection measures of the healthcare provider

5. Appendix 3: Revocation Form: Standard form for revoking consent if patient chooses to do so in the future