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1. Personal Information: Declarant's full legal name, date of birth, address, insurance number, and contact details
2. Declaration Purpose: Clear statement of the purpose for which this health declaration is being made
3. Current Health Status: Declaration of current health conditions, symptoms, medications, and treatments
4. Medical History: Overview of relevant past medical conditions, surgeries, and treatments
5. COVID-19 Status: Specific declarations regarding COVID-19 exposure, vaccination, and test results
6. Contact History: Declaration of recent contact with infected persons or travel to risk areas
7. Data Protection Notice: GDPR-compliant information about data processing, storage, and sharing
8. Consent Statement: Express consent for data processing and sharing with relevant healthcare providers
9. Truth Statement: Declaration that all provided information is true and complete
10. Electronic Signature: Legal electronic signature section compliant with German signature laws
1. Emergency Contact Information: Optional section for providing emergency contact details - recommended for workplace or institutional declarations
2. Vaccination Records: Detailed vaccination history - include when required by specific institutions or for travel purposes
3. Insurance Information: Health insurance details - include when declaration is for insurance or healthcare provider use
4. Specific Risk Factors: Additional health risk factors - include for high-risk environments or activities
5. Language Preference: Preferred language for medical communication - include in multilingual settings
6. Disability Accommodations: Special needs or accommodations - include when relevant for workplace or institutional settings
1. Schedule A - Symptoms Checklist: Detailed checklist of specific symptoms to be completed by declarant
2. Schedule B - Privacy Notice: Detailed GDPR-compliant privacy notice explaining data processing practices
3. Schedule C - Consent Forms: Specific consent forms for different types of data processing and sharing
4. Appendix 1 - Medical Terms Glossary: Definitions of medical terms used in the declaration
5. Appendix 2 - Contact List: List of relevant medical contacts and authorities
6. Appendix 3 - Data Processing Information: Detailed information about how health data will be processed and protected
Healthcare
Education
Manufacturing
Hospitality
Sports and Recreation
Transportation
Financial Services
Insurance
Public Administration
Tourism
Retail
Construction
Pharmaceuticals
Food Service
Childcare
Human Resources
Occupational Health and Safety
Legal and Compliance
Data Protection
Risk Management
Employee Relations
Medical Services
Facilities Management
Administrative Services
International Mobility
Insurance Operations
Human Resources Manager
Occupational Health Officer
Data Protection Officer
Health and Safety Manager
Compliance Officer
Medical Director
School Administrator
Facility Manager
Risk Manager
Employee Relations Specialist
Healthcare Administrator
Immigration Officer
Travel Coordinator
Insurance Underwriter
Corporate Medical Officer
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