ºÚÁÏÊÓÆµ

Authorisation To Release Health Care Information Template for England and Wales

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Authorisation To Release Health Care Information

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Authorisation To Release Health Care Information

"I need an Authorisation To Release Health Care Information for transferring my complete medical history from London Bridge Hospital to my new GP practice in Manchester, with the authorization valid from 1st March 2025 to 1st June 2025."

Document background
The Authorisation To Release Health Care Information is a crucial document required when healthcare information needs to be shared between providers or with third parties in England and Wales. It ensures compliance with data protection laws while facilitating necessary information sharing. This document is commonly used when patients need their medical records transferred between healthcare providers, shared with insurance companies, or accessed by legal representatives. It includes specific details about what information can be released, to whom, and for what duration, while incorporating safeguards required by UK GDPR and healthcare privacy regulations.
Suggested Sections

1. Patient Information: Full name, date of birth, address, contact details, NHS number of the patient whose records are being requested

2. Healthcare Provider Details: Name, address and contact information of the healthcare provider/organization holding the records

3. Information to be Released: Specific description of the medical information to be disclosed, including type of records and date ranges

4. Purpose of Disclosure: Clear statement of the reason for requesting the information release

5. Recipient Information: Complete details of the person or organization who will receive the information

6. Duration of Authorization: Specified time period for which the authorization remains valid

7. Patient Rights Statement: Comprehensive statement of patient rights under UK GDPR and other applicable laws

8. Signature Block: Designated space for patient/authorized representative signature, date, and declarations

Optional Sections

1. Special Instructions: Additional requirements for handling or transmitting the information

2. Representative Authority: Section for documenting legal authority when someone other than the patient is authorizing the release

3. Witness Section: Space for witness details and signature when required by healthcare provider policy

Suggested Schedules

1. Identity Verification Requirements: List of acceptable identification documents and verification procedures

2. Fee Schedule: Schedule of any applicable charges for record copying and processing

Authors

Alex Denne

Head of Growth (Open Source Law) @ ºÚÁÏÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions

























Clauses




















Industries

UK General Data Protection Regulation (UK GDPR): Primary data protection legislation covering principles of data protection, lawful basis for processing, special category data requirements, and data subject rights

Data Protection Act 2018: UK implementation of GDPR including additional provisions for health data and safeguards for processing special category data

Access to Health Records Act 1990: Legislation governing rights of access to health records and provisions regarding deceased patients' records

Common Law Duty of Confidentiality: Legal principle covering medical information confidentiality requirements and patient consent principles

Mental Capacity Act 2005: Legislation covering provisions for individuals lacking capacity and requirements for representatives/attorneys

Health and Social Care Act 2012: Legislation establishing information governance requirements and NHS information sharing frameworks

Caldicott Principles: Guidelines for handling patient information and confidentiality standards in healthcare

Professional Guidelines: Regulatory guidance from GMC (General Medical Council), NHS Digital, and Information Commissioner's Office (ICO)

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Vehicle Release Form Towing

find out more

Vehicle Release Authorisation Form

find out more

Vehicle Property Release Form

find out more

Transcript Release Authorisation

find out more

Temporary Medical Permission Form

find out more

Temporary Guardian Medical Release Form

find out more

Simple Release Form

find out more

Simple Medical Release Form

find out more

Simple Medical Consent Form

find out more

Return To Work Medical Release

find out more

Release Of Medical Records To Family Members Form

find out more

Release Of Information Form For Rental History

find out more

Release Of Care Form

find out more

Release Letter Form

find out more

Protected Health Information Form

find out more

Probate Receipt And Release Form

find out more

Printable Medical Records Release Authorisation Form

find out more

Printable Media Release Form

find out more

Printable Dental Release Form

find out more

Physical Therapy Release Form

find out more

Photo Printing Rights Release Form

find out more

Permission To Use Photo Agreement

find out more

Paid In Full Release Form

find out more

Package Release Form

find out more

Military Medical Records Request Form

find out more

Mental Health Records Release Form

find out more

Medical Treatment Authorisation Form

find out more

Medical Treatment Authorisation And Consent

find out more

Medical Release Form To Return To Work

find out more

Medical Release Form For Family Members

find out more

Medical Release Consent Form

find out more

Medical Consent Authorisation Form

find out more

Licence Release Form

find out more

Legal Release Form

find out more

Letter Of Consent Medical Authorisation Form

find out more

Impound Release Form

find out more

Hospital Release Form

find out more

Hitech Release Form

find out more

Generic Printable Medical Records Release Authorisation Form

find out more

General Release Of Information Consent Form

find out more

General Medical Record Release Form

find out more

General Authorisation To Release Information Form

find out more

Employment Verification Release

find out more

Employer Release Of Information Form

find out more

Emergency Medical Treatment Authorisation Form

find out more

Emergency Medical Authorisation Form

find out more

Driving Record Consent Form

find out more

Dental Release Form

find out more

Dental Records Request Form

find out more

Dental Photo Consent Form

find out more

Dental Patient Release Form

find out more

Dental Medical Records Release Form

find out more

Daycare Medical Release Form

find out more

Consent To Release Personal Information Form

find out more

Consent To Release Medical Records

find out more

Consent For Release Of Protected Health Information

find out more

Client Authorisation To Release Information To Third Parties

find out more

Car Title Lien Release Letter

find out more

Basic Photography Release Form

find out more

Background Release Form

find out more

Authorisation To Use And Disclose Protected Health Information Form

find out more

Authorisation To Release Records

find out more

Authorisation To Release Personal Information

find out more

Authorisation To Release Loan Information

find out more

Authorisation To Release Legal File

find out more

Authorisation To Release Information To Family Members

find out more

Authorisation To Release Information To A Third Party Form

find out more

Authorisation To Release Information

find out more

Authorisation To Release Immunization Records

find out more

Authorisation To Release Health Care Information

find out more

Authorisation To Release Credit Information Form

find out more

Authorisation To Disclose Information

find out more

Authorisation Letter For Release Of Information

find out more

Authorisation For Disclosure Of Information Form

find out more

Authorisation For Disclosure

find out more

Authorisation Disclosure Form

find out more

Authorisation For Release Of Protected Health Information Phi

find out more

Authorisation For Release Of Personal Information

find out more

Authorisation For Release Of Information Form

find out more

Authorisation For Release Of Health Records

find out more

Authorisation For Release Of Health Information

find out more

Authorisation For Release Of Financial Information

find out more

Authorisation For Release Of Employment Records

find out more

Authorisation For Release Of Employment Information

find out more

Authorisation For Release Of Dental Records

find out more

Authorisation For Release Of Confidential Information

find out more

Authorisation For Release Of Cell Phone Records

find out more

Authorisation For Disclosure Of Protected Health Information Form

find out more

Authorisation For Disclosure Of Medical Information

find out more

Actor Release Form

find out more

Authorisation Of Release Of Unemployment Records Form

A legal form used in England and Wales to authorize the release of individual unemployment records in compliance with UK data protection laws.

find out more

Authorisation For Release Of Records

A legal document under English and Welsh law authorizing the release of specific records from one party to another, in compliance with UK data protection legislation.

find out more

Release Of Information Statement

A legal document under English and Welsh law authorizing and governing the release of specific information between parties while ensuring data protection compliance.

find out more

Printable Work Release Form

A legally binding document under English and Welsh law that formalizes the termination of employment and mutual release of claims between employer and employee.

find out more

Dental Release Of Information Form

A legal document under English and Welsh law authorizing the release of dental records and information to specified parties.

find out more

Work Release Form From Doctor

A medical document used in England and Wales certifying an employee's fitness to return to work, compliant with UK healthcare and employment regulations.

find out more

Universal Medical Release Form

A legal document under English and Welsh law authorizing the release of medical records to specified parties while ensuring data protection compliance.

find out more

Service Release Form

A legally binding document under English and Welsh law that releases parties from obligations and liabilities related to completed services.

find out more

Revocation Of Release Of Information Form

An English and Welsh law-compliant document for withdrawing previously granted authorization for information sharing and processing.

find out more

Release Form For Video Recording

A legal document under English and Welsh law that obtains consent for video recording and establishes usage rights for the recorded content.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: /our-research
Oops! Something went wrong while submitting the form.

³Ò±ð²Ô¾±±ð’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; ³Ò±ð²Ô¾±±ð’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our for more details and real-time security updates.