Personal Information Consent Form

Personal Information Consent Form Template for Netherlands

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Key Requirements PROMPT example:

"I need a Personal Information Consent Form for my medical clinic in Amsterdam that covers both general patient data and special category health data processing, including sharing with specialist healthcare providers and insurance companies."

Document background

The Personal Information Consent Form is a crucial document required whenever organizations in the Netherlands collect and process personal data based on consent as their legal basis under the GDPR. This document becomes necessary when other legal bases (such as contractual necessity or legitimate interests) are not applicable or when explicit consent is specifically required, such as for processing special categories of personal data. The form must comply with both the EU GDPR and the Dutch UAVG, ensuring that consent is freely given, specific, informed, and unambiguous. It should be used before initiating any data processing activities where consent is the chosen legal basis, and must be maintained as part of the organization's documentation to demonstrate compliance with data protection principles. The document needs regular review and updating to reflect any changes in data processing activities or applicable privacy laws.

Suggested Sections

1. Identity of the Data Controller: Details of the organization collecting and processing the personal data, including contact information

2. Purpose of Processing: Clear explanation of why the personal data is being collected and how it will be used

3. Categories of Personal Data: Specific list of personal data types that will be collected and processed

4. Legal Basis for Processing: Explanation that consent is the legal basis, with reference to GDPR Article 6(1)(a)

5. Data Subject Rights: Description of all rights under GDPR including access, rectification, erasure, and data portability

6. Data Retention Period: How long the personal data will be stored and criteria used to determine this period

7. Data Sharing and Recipients: Information about third parties who may receive the personal data

8. Consent Declaration: Clear, affirmative consent statement and signature section

9. Right to Withdraw Consent: Explanation of how to withdraw consent and the consequences

10. Complaints Procedure: Information about right to lodge complaint with supervisory authority (Dutch DPA)

Optional Sections

1. International Transfers: Required when personal data will be transferred outside the EU/EEA

2. Automated Decision Making: Required when processing involves automated decision-making or profiling

3. Special Categories of Data: Required when processing sensitive personal data (health, biometric, etc.)

4. Children's Data Processing: Required when collecting data from minors, including parental consent provisions

5. Marketing Communications: Required when data will be used for direct marketing purposes

6. Cookie Usage: Required when using cookies or similar tracking technologies

7. CCTV Recording: Required when consent includes video surveillance

8. Employee Data Processing: Required when consent form is used in employment context

Suggested Schedules

1. Schedule 1: Detailed Data Categories: Comprehensive list of all personal data fields being collected

2. Schedule 2: Third Party Recipients: Detailed list of all third parties who may receive the personal data

3. Schedule 3: Technical and Security Measures: Description of security measures implemented to protect personal data

4. Appendix A: Privacy Policy: Full privacy policy reference document

5. Appendix B: Data Subject Request Form: Template form for exercising data subject rights

6. Appendix C: Withdrawal of Consent Form: Template form for withdrawing consent

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��ֱ�� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

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Relevant Teams

Legal

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Data Protection Officer

Privacy Manager

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HR Manager

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Marketing Manager

IT Director

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Chief Information Security Officer

Chief Legal Officer

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