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The Dental Records Release Form is a critical document used in Hong Kong's healthcare system to facilitate the legal and compliant transfer of patient dental records. This document becomes necessary when patients require their records to be transferred to another healthcare provider, need copies for insurance purposes, or require access to their medical information for legal proceedings. The form must comply with Hong Kong's Personal Data (Privacy) Ordinance (Cap. 486) and relevant healthcare regulations, ensuring proper authorization for the release of sensitive medical information while protecting patient privacy rights. It includes comprehensive details about the patient, requesting party, specific records being released, and purpose of the release, while incorporating necessary consent mechanisms and data protection safeguards.

1. Patient Information: Complete identification details of the patient including full name, HKID/passport number, date of birth, and contact information

2. Dental Practice Information: Details of the releasing dental practice, including practice name, address, and responsible dentist's registration number

3. Records Request Details: Specific description of which dental records are being requested, including date ranges and types of records (e.g., x-rays, treatment notes, etc.)

4. Recipient Information: Details of who will receive the records, including name, organization (if applicable), and contact information

5. Authorization Statement: Clear statement authorizing the release of dental records, including the purpose of the release

6. Patient Rights Notice: Statement informing the patient of their rights regarding their dental records under Hong Kong law

7. Signature Block: Space for patient signature (or authorized representative), date, and witness signature if required