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The Psychologist Release of Information Form is a critical document used in New Zealand psychological practice settings when there is a need to share client information with third parties. This document ensures compliance with the Privacy Act 2020, Health Information Privacy Code 2020, and professional psychological practice standards in New Zealand. It is typically used when psychological records need to be shared with other healthcare providers, educational institutions, insurance companies, or legal representatives. The form includes detailed specifications about what information can be shared, with whom, for what purpose, and for how long, while emphasizing the client's rights regarding their personal information. It serves as both a legal protection mechanism and a standardized process for managing sensitive psychological information transfers.

1. Client Information: Full identification details of the client including name, date of birth, contact information, and any relevant identification numbers

2. Psychologist Information: Details of the psychologist or practice, including registration number and contact information

3. Information to be Released: Specific description of what psychological records or information is authorized for release

4. Recipient Information: Details of the person(s) or organization(s) authorized to receive the information

5. Purpose of Release: Clear statement of why the information is being released and how it will be used

6. Duration of Authorization: Specific timeframe for which the authorization is valid

7. Rights and Understandings: Statement of client's rights including right to revoke consent and any implications of giving or withholding consent

8. Signatures and Date: Space for client signature, date, and witness signature if required