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Permission And Medical Release Form
"I need a Permission and Medical Release Form for my 16-year-old daughter to participate in a school sports program starting January 2025, which includes authorization for emergency medical treatment and sharing medical information with both the school nurse and team physician."
1. Personal Information: Details of the person giving consent including full name, date of birth, contact information
2. Medical Information Release Authorization: Specific permissions for accessing and sharing medical information, including scope of authorization and permitted recipients
3. Emergency Contact Information: Details of persons to contact in emergencies, including relationship and contact methods
4. Data Protection Statement: Information about how personal data will be processed, stored, and protected in accordance with UK GDPR
5. Consent Declaration: Clear statement of consent and understanding of the permissions being granted
6. Signature Block: Space for signatures, dates, and witness information where required
1. Minor Consent: Additional section for parental/guardian consent when the subject is under 18
2. Special Medical Conditions: Section for listing specific medical conditions, allergies, or ongoing treatments
3. Duration of Authorization: Specification of time period for which the consent remains valid
4. Mental Capacity Declaration: Additional declarations regarding mental capacity when relevant under Mental Capacity Act 2005
1. Medical History Form: Detailed medical history form including past conditions, surgeries, and medications
2. Specific Procedures Consent: Detailed consent forms for specific medical procedures or treatments
3. Information Sharing Protocol: Detailed protocol specifying how medical information will be shared, including recipient organizations and security measures
4. Privacy Notice: Detailed privacy notice explaining data protection rights and procedures under UK GDPR
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