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1. Patient Information: Essential demographic details including full name (in Arabic and English), national ID/Iqama number, date of birth, contact information, and medical record number
2. Request Details: Specific information about the medical records being requested, including date range, type of records, and purpose of request
3. Identity Verification: Requirements for proving identity, including acceptable forms of government-issued ID and verification process
4. Consent Declaration: Patient's explicit consent for release of medical records, with signature and date
5. Processing Information: Details about processing timeframes, fees (if applicable), and preferred method of record delivery
6. Healthcare Facility Information: Details of the facility/facilities from which records are being requested
1. Third Party Authorization: To be included when someone other than the patient is requesting records, including legal guardian, power of attorney, or other authorized representative
2. Urgent Request: Additional section for expedited processing requests, requiring justification and supporting documentation
3. International Transfer: Special considerations and additional requirements when records are being sent outside Saudi Arabia
4. Deceased Patient: Special requirements and documentation needed when requesting records of a deceased patient
5. Record Amendment Request: Section for requesting corrections or amendments to existing medical records
1. Appendix A - Required Documentation Checklist: List of required supporting documents for different types of requests
2. Appendix B - Privacy Notice: Detailed information about how the patient's information will be handled and protected
3. Appendix C - Fee Schedule: Breakdown of applicable fees for different types of record requests and processing times
4. Appendix D - Acceptable Forms of ID: Comprehensive list of acceptable identification documents for Saudi nationals and residents
5. Appendix E - Authorization Forms: Template forms for third-party authorization and special circumstances
Healthcare
Medical Services
Hospital Administration
Clinical Services
Legal Services
Healthcare Information Management
Data Protection
Medical Insurance
Public Health
Medical Records
Patient Services
Legal Affairs
Compliance
Health Information Management
Quality Assurance
Patient Relations
Administrative Services
Data Protection
Clinical Documentation
Medical Records Officer
Health Information Manager
Compliance Officer
Healthcare Administrator
Patient Services Coordinator
Medical Secretary
Legal Affairs Specialist
Data Protection Officer
Quality Assurance Manager
Healthcare Facility Director
Patient Relations Manager
Clinical Documentation Specialist
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