Protected Health Information Form Template for Denmark

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Protected Health Information Form

I need a Protected Health Information Form for my Copenhagen-based dental clinic that will be opening in March 2025, with specific provisions for sharing patient data with external laboratories and specialists while ensuring GDPR compliance and Danish healthcare regulations.

What is a Protected Health Information Form?

The Protected Health Information Form is a crucial document required under Danish law for healthcare providers and medical institutions operating in Denmark. It emerged from the need to comply with both the EU GDPR and specific Danish healthcare regulations, particularly the Danish Health Act and Data Protection Act. This form must be used whenever healthcare providers collect and process patient health information, serving as both a legal compliance document and a transparent explanation for patients about how their sensitive health data will be handled. The document addresses the stringent requirements for processing special categories of personal data under GDPR Article 9, while incorporating specific Danish healthcare privacy standards. It's particularly important in modern healthcare settings where patient data is increasingly digitized and shared among various healthcare providers and systems.

What sections should be included in a Protected Health Information Form?

1. Data Controller Information: Identity and contact details of the healthcare provider/organization collecting the data, including DPO contact information

2. Purpose of Data Collection: Clear explanation of why the health information is being collected and how it will be used

3. Categories of Personal Data: Detailed list of the types of health and personal information being collected

4. Legal Basis: Legal grounds for processing health data under GDPR Article 9 and Danish law

5. Data Recipients: Information about who will have access to the health data and under what circumstances

6. Data Retention: How long the health information will be stored and criteria for determining retention periods

7. Data Subject Rights: Explanation of patient rights under GDPR and Danish law, including access, rectification, and deletion rights

8. Security Measures: Overview of measures taken to protect the health information

9. Consent Declaration: Clear, specific consent statements with separate signature lines for different processing activities

What sections are optional to include in a Protected Health Information Form?

1. International Transfers: Include when health data may be transferred outside Denmark/EU, explaining safeguards and legal basis

2. Research Purposes: Include when data may be used for medical research, explaining specific conditions and additional rights

3. Emergency Contact Authorization: Include when allowing designation of persons who can access information in emergencies

4. Digital Health Services: Include when electronic health records or digital health services are involved

5. Special Processing Activities: Include when automated decision-making or profiling is used in healthcare context

What schedules should be included in a Protected Health Information Form?

1. Schedule A - Detailed Data Categories: Comprehensive list of all types of health data collected, including specific medical categories

2. Schedule B - Security Protocols: Detailed description of technical and organizational security measures

3. Schedule C - Third Party Recipients: List of specific third parties who may receive the data (e.g., laboratories, specialists, researchers)

4. Appendix 1 - Patient Rights Guide: Detailed explanation of all patient rights and how to exercise them

5. Appendix 2 - Privacy Notice: Supplementary detailed privacy notice as required by GDPR Article 13/14

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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Healthcare

Medical Research

Pharmaceuticals

Biotechnology

Health Insurance

Digital Health

Medical Devices

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Telemedicine

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Legal

Compliance

Privacy

Healthcare Administration

Information Security

Medical Records

Risk Management

Quality Assurance

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Data Protection

Relevant Roles

Data Protection Officer

Privacy Officer

Healthcare Administrator

Medical Director

Compliance Manager

Legal Counsel

Healthcare Privacy Specialist

Clinical Director

IT Security Manager

Quality Assurance Manager

Medical Records Manager

Chief Medical Officer

Healthcare Operations Manager

Risk Management Officer

Information Governance Manager

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Let's create your Protected Health Information Form

What is a Protected Health Information Form?

What sections should be included in a Protected Health Information Form?

What sections are optional to include in a Protected Health Information Form?

What schedules should be included in a Protected Health Information Form?

Authors

Alex Denne

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