The Medical Records Release Authorization Form is essential in Singapore's healthcare system for managing the confidential transfer of patient medical information. This document is required whenever a patient or their legal representative needs to authorize the release of medical records to third parties, such as other healthcare providers, insurance companies, or legal representatives. It ensures compliance with Singapore's strict data protection laws, including the PDPA and HCSA, while protecting patient privacy rights. The form includes comprehensive details about the scope of information to be released, timeframes, and specific use permissions.
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1. Patient Information: Full name, NRIC/passport number, date of birth, contact details of the patient authorizing release
2. Healthcare Provider Information: Name, address, and contact details of the healthcare facility/provider holding the medical records
3. Scope of Authorization: Detailed specification of which medical records are being authorized for release, including date ranges and types of records
4. Recipient Information: Details of person, healthcare provider, or entity authorized to receive the medical records
5. Duration of Authorization: Specific time period for which this authorization remains valid
6. Patient Rights Statement: Comprehensive statement of patient's rights regarding their medical information and this authorization
1. Legal Representative Authorization: Section for details and authorization when someone other than the patient is making the request
2. Specific Exclusions: Section detailing any specific medical records or information that should NOT be released
3. Emergency Contact: Section for alternative contact person details in case of emergency or inability to reach the patient
1. Schedule A - List of Requested Records: Detailed inventory of specific medical records being requested for release
2. Schedule B - Identity Documents: Copies of required identification documents of patient and/or requestor
3. Schedule C - Legal Documentation: Supporting legal documents for representatives, including power of attorney or court orders if applicable
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