The Consent To Release Information Form is a crucial document in the Philippine legal framework, designed to comply with the Data Privacy Act of 2012 (RA 10173) and its Implementing Rules and Regulations. This document is essential when organizations need to share personal information with third parties, requiring explicit consent from the data subject. The form should be used whenever personal information needs to be collected, processed, or shared beyond the original purpose for which it was collected. It typically includes details about the data subject, the requesting organization, the specific information to be released, intended recipients, purpose of disclosure, and duration of consent. The document serves as evidence of compliance with Philippine data privacy regulations and protects both the data subject's rights and the organization's legal obligations.
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1. Parties: Identification of the data subject (person giving consent), the organization requesting consent, and any third parties who will receive the information
2. Purpose of Disclosure: Clear statement of the specific purpose(s) for which the information will be released and how it will be used
3. Information to be Released: Detailed description of the specific information or records to be disclosed
4. Duration of Consent: Specified period for which the consent remains valid, including start and end dates if applicable
5. Rights of the Data Subject: Statement of the data subject's rights under the Data Privacy Act, including right to withdraw consent
6. Data Privacy Notice: Mandatory privacy notice as required by the Data Privacy Act of 2012
7. Execution: Signature blocks, date, and witness provisions if required
1. Special Categories of Data: Additional provisions for sensitive personal information such as health records, financial information, or government-issued IDs
2. Electronic Processing Consent: Specific consent for electronic processing and storage of information, required when digital systems are used
3. International Transfer Provisions: Additional provisions required when information will be transferred outside the Philippines
4. Revocation Procedure: Detailed procedure for withdrawing consent, including specific contact information and process
5. Emergency Contact Authorization: Additional authorization for emergency contacts to access information, typically used in medical contexts
1. Schedule A - Detailed Information List: Itemized list of specific information or documents to be released
2. Schedule B - Authorized Recipients: List of specific individuals or organizations authorized to receive the information
3. Schedule C - Processing Activities: Detailed description of how the information will be processed, stored, and protected
4. Appendix 1 - Data Subject Rights: Detailed explanation of data subject rights under Philippine law
Authors
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Relevant Industries
Healthcare
Banking and Finance
Education
Human Resources
Insurance
Government Services
Legal Services
Real Estate
Telecommunications
Social Services
Relevant Teams
Legal
Compliance
Human Resources
Information Security
Risk Management
Data Privacy
Records Management
Operations
Administrative Services
Customer Service
Relevant Roles
Data Protection Officer
Privacy Officer
Compliance Manager
Human Resources Manager
Medical Records Officer
Legal Counsel
Information Security Officer
Risk Management Officer
Records Manager
Operations Manager
Healthcare Administrator
School Registrar
Bank Officer
Insurance Claims Officer
Government Administrator
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