HIPAA Privacy Policies & Procedures Templates

Why create HIPAA Privacy Policies?

All covered entities are required to create HIPAA Privacy Policies as per the guidelines of the HIPAA Privacy policy rule. Most of these policies are used in day-to-day administration.

“Essentially, a covered entity is required to develop and implement policies and procedures appropriate to the entity’s business practices and workforce that reasonably minimize the amount of protected health information used, disclosed, and requested;” – HIPAA Privacy Rule 45 CFR Part 160.

Who can use HIPAA Privacy Policies Templates Suite? Our HIPAA privacy policy template can be used by Healthcare entities like Hospitals, Insurers, Long Term Care/Skilled Nursing Facilities, Ambulatory Surgery Centers, Assisted Living/Intermediate Care Facilities, Clinical Laboratories, Clinics, Dialysis Providers, Employer Plans, HMOs, Home Health Agencies, Hospices, Pharmacies, Physicians, PPOs, Rehabilitation Facilities, other payees & providers and business associates of healthcare organizations.

Our templates for covered entities can jump-start your HIPAA Privacy Policy and Procedures project and save you a lot of time for your team and money. HIPAA Privacy Policy and Procedures templates suite have 57 documents that have been customized to help you meet a requirement of the HIPAA Privacy Rule.

Following are the 57 HIPAA forms, policies, and procedures included in the HIPAA Privacy Policy & procedures template suite. The policies can be used by any covered entity. All policies are available in MS Word format and can be easily customized as per your requirements. Each template is presented in a standard format reflecting critical organizational functions to consider in HIPAA remediation.

These HIPAA Forms cover all the major areas like:

  1. General policies regarding use and disclosure of PHI
  2. The minimum necessary rule for use and disclosure of PHI
  3. Patient rights regarding their own PHI
  4. Uses and disclosures not requiring patient authorization
  5. Special cases for restriction of uses and disclosures of PHI
  6. Organizational issues and safeguards

The templates suite includes the following HIPAA Privacy Form, Policy, and procedures.

  • Accept Access Request
  • Accounting for Disclosures
  • Acknowledgment of Receipt
  • Amendment to Record Form
  • Authorization for Release of Protected Health Information
  • Authorization To Use Disclose Protected Health Information
  • Business Associate Agreement
  • Business Associate Contracts and Other Arrangements
  • Complaint Process
  • Data Use Agreement Template
  • De-identified Information and Limited Data Sets
  • Denial Access Request
  • Denial Request to Amend Form
  • Disclosure Accounting Log for Medical Information
  • Disclosure of PHI with and without authorization Template
  • Disclosures Record Form
  • Document Retention Requirements
  • EHR accounting of disclosures
  • Employee Confidentiality Agreement
  • Execution of Business Associate Agreements with Contracts
  • Health Plan Notice of Privacy Practices
  • HIPAA Accept Amend Request Form
  • Identifying PHI and Designated Record Sets
  • Minimum Necessary
  • Multi-Organization Arrangements
  • Notice of Privacy Practices
  • Patient Right to Access PHI
  • PHI Release by Whistleblowers
  • Privacy Officer
  • Receipt of Payment when Disclosing PHI
  • Release for Abuse Neglect or Domestic Violence
  • Release for Confidential Communications
  • Release for Fundraising Purposes
  • Release for Health Oversight
  • Release for Judicial or Administrative Proceedings
  • Release for Law Enforcement
  • Release for Marketing Purposes
  • Release for Public Health
  • Release for Research Purposes
  • Release for Specific Government Functions
  • Release for Workers Compensation
  • Release of Information for Deceased Patients or Plan Members
  • Release of Information for Legal Representatives
  • Release of Information to a Minor
  • Release of Information to a Minor’s Parents
  • Release of Information to Friends and Family Members
  • Release of Psychotherapy Notes
  • Release to Avert Serious Threat to Safety
  • Request Confidential Communications Template
  • Request Restriction
  • Request to Amend Patient or Plan Member Record
  • Requests for Restriction policy
  • Required PHI Disclosures
  • Right to Object to Release for Certain Purposes
  • Safeguarding PHI
  • Training Requirements
  • Workforce Sanctions


View Sample Template: Authorization for Release of Information
View HIPAA Template’s License

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The templates are available in our online HIPAA store for purchase. All the templates come in Microsoft Word/excel files so you can add, change and delete the content as required to complete your HIPAA Forms. If you have any questions, please feel free to contact us at Bob@HIPAAcertification.net or call on (515) 865-4591