The Medical Release of Information Form is a critical document in the Australian healthcare system that facilitates the secure and compliant sharing of patient medical information between authorized parties. This form is required whenever protected health information needs to be shared beyond the immediate healthcare provider, whether for continued medical care, insurance purposes, legal proceedings, or other authorized reasons. It ensures compliance with the Privacy Act 1988 (Cth), state-specific health records legislation, and the Australian Privacy Principles. The form includes comprehensive patient identification, specific authorization details, temporal limitations, and clear articulation of patient rights, serving as both a legal authorization and a record of consent for information sharing.
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1. Patient Information: Essential identifying information including full name, date of birth, address, contact details, and healthcare identifier number
2. Healthcare Provider Details: Information about the healthcare provider/facility releasing the information, including name, address, and contact information
3. Recipient Information: Details of the person or organization authorized to receive the medical information
4. Information to be Released: Specific description of what medical information is authorized for release, including date ranges and types of records
5. Purpose of Release: Statement of the reason for releasing the information (e.g., continuing care, legal purposes, insurance)
6. Duration of Authorization: Specification of how long the authorization remains valid
7. Rights and Notices: Statement of patient rights including right to revoke authorization and any limitations
8. Privacy Statement: Reference to Privacy Act 1988 and relevant state legislation, explaining how information will be handled
9. Signature Block: Space for patient signature, date, and witness if required
1. Sensitive Information Authorization: Additional authorization for release of sensitive information such as mental health records, HIV status, or genetic information
2. Electronic Records Consent: Specific consent for release of information from electronic health record systems
3. Third Party Authorization: Authorization for someone other than the patient to request records (e.g., legal guardian, power of attorney)
4. Interstate/International Transfer: Additional provisions for when information is being transferred across state or international borders
5. Fee Schedule: Information about any applicable fees for record copying and transfer
1. Schedule A - Types of Medical Records: Detailed checklist of specific types of medical records that can be released (e.g., pathology reports, imaging reports, consultation notes)
2. Schedule B - Privacy Policy Summary: Summary of relevant privacy policies and patient rights regarding their medical information
3. Schedule C - Fee Structure: Detailed breakdown of any applicable fees for different types of records or processing times
4. Appendix 1 - Glossary: Definitions of medical and legal terms used in the form
Authors
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Medical Services
Insurance
Legal Services
Healthcare Technology
Medical Research
Aged Care
Mental Health Services
Allied Health Services
Public Health
Relevant Teams
Medical Records
Compliance
Legal
Patient Services
Health Information Management
Privacy and Data Protection
Risk Management
Administration
Clinical Operations
Quality Assurance
Relevant Roles
Medical Records Manager
Privacy Officer
Healthcare Administrator
Medical Practice Manager
Compliance Officer
Health Information Manager
Medical Secretary
Clinical Director
Legal Counsel
Risk Manager
Patient Services Coordinator
Medical Records Clerk
Practice Administrator
Healthcare Privacy Specialist
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