The Medical Release of Information Form serves as a crucial document in Hong Kong's healthcare ecosystem, enabling the controlled and compliant sharing of medical information between authorized parties. This document becomes necessary when medical information needs to be shared beyond the primary healthcare provider, such as with insurance companies, other medical facilities, or employers. It is designed to comply with Hong Kong's Personal Data (Privacy) Ordinance and healthcare regulations, providing a structured process for requesting and releasing medical information while protecting patient privacy rights. The form includes comprehensive details about the scope of information to be released, temporal validity, and specific usage permissions, ensuring that sensitive medical data is handled appropriately and securely. This document is particularly important in situations requiring proof of medical condition, insurance claims, continued care at different facilities, or employment-related medical verifications.
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1. Patient Information: Detailed identification of the patient including full name, HKID/passport number, date of birth, and contact information
2. Healthcare Provider Information: Details of the healthcare provider/facility currently holding the medical records
3. Recipient Information: Information about the person or entity authorized to receive the medical information
4. Information to be Released: Specific description of medical information authorized for release, including date ranges and types of records
5. Purpose of Disclosure: Clear statement of the reason(s) for releasing the medical information
6. Duration of Authorization: Specification of how long the authorization remains valid
7. Rights and Notices: Statement of patient's rights regarding the release of information, including right to revoke authorization
8. Acknowledgment and Authorization: Formal authorization statement and signature section
1. Specific Exclusions: Section to explicitly list any medical information that should NOT be released - used when patient wants to restrict certain sensitive information
2. Third Party Authorization: Additional section when someone other than the patient is authorized to sign the release - used for minors or individuals with appointed representatives
3. Electronic Distribution Authorization: Specific authorization for electronic transmission of records - used when digital transfer is anticipated
4. Urgent Request Designation: Section indicating urgent processing requirements - used for time-sensitive medical situations
5. Re-disclosure Notice: Additional provisions regarding subsequent sharing of released information - used for sensitive cases or when information may be shared with multiple parties
1. Schedule A - Types of Medical Records: Detailed checklist of specific types of medical records that may be released (e.g., laboratory results, imaging reports, consultation notes)
2. Schedule B - Fee Schedule: List of applicable fees for different types of record requests and processing times
3. Appendix 1 - Identity Verification Requirements: List of acceptable identification documents and verification procedures
4. Appendix 2 - Privacy Policy Summary: Summary of relevant privacy policies and data protection measures in accordance with Hong Kong law
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Medical Records
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Patient Services
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Medical Records Officer
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Healthcare Administrator
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Clinical Administrative Coordinator
Patient Services Representative
Medical Office Manager
Compliance Coordinator
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