HIPAA Forms & Policies

Forms

• Complaint Form (see “Complaint Procedure” below)
• Health Record Correction/Amendment Form and Policy
• Request for Restrictions on Use and Disclosure
• Request Confidential Communication Policy and Form

Notice of Privacy Practices, Policies, Procedures and Statements

• Accessing, Inspecting and Obtaining a Copy of Health Information
• Accounting of Disclosures of Protected Health Information (PHI) Policy
• Complaint Procedure
• Minimum Necessary
• Notice of Privacy Practices – Adams School of Dentistry
• Notice of Privacy Practices – Campus Health Services
• Notice of Privacy Practices – Psychology and Neuroscience Clinic
• PHI Confidentiality Statement
• Privacy of Protected Health Information Policy
• Protocol for Responding to Breaches of Protected Health Information
• Research Policy
• HIPAA Hybrid Entity and Covered Component Designation
• Training Policy and Procedures
• HIPAA Sanctions Standard