Dental Medical Release Form

Dental Medical Release Form Template for England and Wales

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Key Requirements PROMPT example:

"I need a Dental Medical Release Form for my new private dental practice in London, which will handle both NHS and private patients, with specific clauses for clinical photography and research data usage."

Document background

The Dental Medical Release Form is a crucial document required by dental practices operating in England and Wales to ensure compliance with healthcare regulations and data protection laws. It serves multiple purposes: documenting patient medical history, obtaining informed consent for treatment, and securing authorization for sharing medical information with other healthcare providers when necessary. This form is essential for risk management, legal compliance, and maintaining complete patient records. It must comply with the UK GDPR, Data Protection Act 2018, and General Dental Council guidelines.

Suggested Sections

1. Patient Information: Basic personal details and contact information including full name, date of birth, address, and contact numbers

2. Medical History: Current medical conditions, medications, allergies, and previous medical treatments

3. Consent Statement: Express permission for dental treatment and information sharing, including acknowledgment of risks

4. Emergency Contact Details: Alternative contact information including name, relationship, and contact numbers

5. Data Protection Notice: Information about how personal data will be processed, stored, and shared in compliance with UK GDPR

Optional Sections

1. NHS Treatment Declaration: Additional declarations required for NHS dental treatment patients

2. Guardian Consent: Additional consent section for patients under 18 or those lacking mental capacity

3. Interpreter Declaration: Additional section when language assistance is required, including interpreter details

4. Photography Consent: Optional consent for clinical photography for treatment documentation

Suggested Schedules

1. Treatment Plan: Detailed outline of proposed dental procedures and expected outcomes

2. Fee Schedule: Comprehensive breakdown of treatment costs and payment terms

3. Patient Rights Information: Summary of patient rights, complaints procedure, and relevant contact information

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��Ƶ | 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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Authors

Alex Denne

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