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1. Financial Considerations: Used when there are any financial implications or compensation related to the publication

2. Third Party Access: Include when the publication may be accessed or used by parties beyond the primary publisher

3. Translation Rights: Required when the publication may be translated into other languages

4. Future Research Use: Include when the published information might be used for future research purposes

5. Family Member Information: Needed when the case includes relevant family medical history or information about family members

6. Special Category Data: Required when publishing sensitive information about race, religion, or other special category data

1. Schedule 1 - Details of Publication: Specific details about the intended publication(s), including journal names, formats, and timelines

2. Schedule 2 - Information Schedule: Detailed list of all medical information, images, or data to be included in the publication

3. Schedule 3 - Privacy Protocol: Detailed procedures for ensuring patient anonymity and data protection

4. Appendix A - Sample Publication Materials: Examples of how the information will be presented in publication, if available

5. Appendix B - Patient Rights Summary: Simplified summary of patient rights under Philippine law regarding medical data publication

6. Appendix C - Withdrawal Form: Template form for withdrawing consent if the patient chooses to do so later