HIPAA Forms

This "course" would be more aptly described as a downloadable library. The following forms may be downloaded instantly upon purchase, in .doc format, ready for you to add your practice information, edit as you wish, and USE! PDF and JPG formats available upon request.

HIPAA Documents for Internal Use

Staff Confidentiality Agreement

Record of Chart Movement

Fax Cover Sheet

Email Notice

Business Associate Confidentiality Agreement

Privacy Policies Training Acknowledgement

HIPPAA Documents for Use With Clients/Patients

Restriction of Use and Disclosures Request Form

Notice of Privacy Practices, short summary

Notice of Privacy Practices, detailed form

Medical Release, two way

Medical Records release to midwife

Disclosure of Protected Health Information

Consent and Release of Information or Images

Confidential Health Information

Conditions of Service

Birth Center Notice of Privacy Practices

Amendment of Health Record Request Form

Acknowledgement of Receipt of Privacy Policy, long form

Acknowledgement of Receipt of Notice of Privacy Practices, simple form

Accounting of Disclosures Request form

For instructions on how to use these forms, and how to be in compliance with new HIPAA standards, we recommend you take Maryl Smith's course that is a companion to these documents: A Heappa HIPAA Help...and Heroic Updates. 

If you wish to purchase both the course and the forms, you may do so together for $20 off by selecting the HIPAA Heroes Bundle at the very bottom of this page.

Cartoon by R.J. Romero and used with permission.