Sample Business Associate Contract
Sample business associate contract contained in the Appendix to the final regulations of August 2002, with HHS commentary and description.
Sample Notice of Privacy Practices
Prepared by the American Health Information Management Association. Note that this page includes a great deal of information about the notice and the sample notice has a blue background and is below the Sample Notice for Alcohol/Drug Patient Records.
Sample Notice of Privacy Practices.
Sample Notice of Privacy Practices form contained in the proposed HIPAA privacy rules.
This form was not published in the final rules and the user should note
carefully that this model does not include all of the required elements set
forth in the final rule, but can be used as guidance on the style and format of a Notice.
Model Authorization Form
Model authorization form contained in the proposed HIPAA privacy rules. This form was not published in the final rules and the user should note carefully that this model does not include all of the required elements set forth in the final rule, but can be used as guidance on the style and format of an authorization.
Sample Consent for Uses and Disclosures Form
Prepared by the American Health Information Management Association
Sample Amendment Policy and Procedure
Sample policy and procedure for handling requests for amendments to protected health information. Prepared by the American Health Information Management Association. Note that this page includes information about amendments and the sample policy has a blue background and is about half way down the page.
