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HIPAA Policies and Forms
 

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Definitions 
(under construction)

Chapter 1     Use and Disclosure of Protected Health Information

1.1       General Rule:  Uses and Disclosures of Information (MS WORD) (PDF)
1.2       De-identification of Information
(MS WORD) (PDF)
1.3       Minimum Necessary
(MS WORD) (PDF)
1.4       Data Gathered Prior to April 14, 2003
(MS WORD) (PDF)
1.5       Sanctions Applicable to Workforce for Violation of Policies (MS WORD) (PDF)
1.6       Verification of Individuals
(MS WORD) (PDF)
1.7       Retention of Records
(MS WORD) (PDF)

Chapter 2     Notice of Privacy Practices

2.1       Notice of Privacy Practices Policy (MS WORD) (PDF)
2.2       Notice of Privacy Practices Document
(MS WORD) (PDF); (para espaņol)  
2.3       Notice of Privacy Practices Acknowledgment Form 
(PDF); (para espaņol)

Chapter 3     Authorization

3.1       Valid Authorization (MS WORD) (PDF)
3.2       When No Authorization is Required to Use or Disclose PHI
(MS WORD) (PDF)
3.3       Authorization Required to Use or Disclose PHI contained in Psychotherapy Notes
                (MS WORD) (PDF)
3.4       Conditioning Receipt of Services on Providing Authorization
(MS WORD) (PDF)
3.5       Revoking Authorization
(MS WORD) (PDF)
3.6       Authorization Forms
3.7       Authorization for Public Relations Purposes
(MS WORD) (PDF)

Chapter 4     Uses and Disclosures Without the Need for an Authorization

4.1       Research Purposes (under construction)
4.2       Required by Law (under construction)
4.3       Permitted Disclosures: Opportunity to Agree or Object
(MS WORD) (PDF)
4.4       Deceased Research Certification Form
(MS WORD)
4.5       Limited Data Sets 
(MS WORD) (PDF)
4.6       Pre-Research Certification Form (MS WORD)

Chapter 5     Marketing and Fundraising

5.1       Marketing (MS WORD) (PDF)
5.2       Fundraising
(MS WORD) (PDF)

Chapter 6     Individual Rights

6.1       Right to Request Restrictions (MS WORD) (PDF)
6.2       Right to Request Confidential Communications
(MS WORD) (PDF)
6.3       Right to Request Amendments
(MS WORD) (PDF)
6.4       Right to Access and Copy
(MS WORD) (PDF)
6.5       Right to an Accounting - Disclosure Tracking Mechanisms
(MS WORD) (PDF)
6.5       Disclosure Tracking Form 
(MS WORD) 
6.6       No Waiver of Rights (MS WORD) (PDF)
6.7       Process for Complaints
(MS WORD) (PDF)

Chapter 7     Institutional Requirements

7.1       Safeguards (MS WORD) (PDF)
7.2       Training
(MS WORD) (PDF)

Chapter 8     Contracts

8.1       Busniess Associates Privacy Practices (MS WORD) (PDF)
8.2       Business Associates Contracts Policy (under construction)
8.3       Business Associates Contract Template
(MS WORD) (PDF)
8.4       Data Use Agreement Template
(MSWORD) (PDF)

Chapter 9     Security

9.1       Security Management (MS WORD) (PDF)
9.2       Security Incidents (MS WORD) (PDF)
9.3       Auditing (MS WORD) (PDF)
9.4       Workforce Security
(MS WORD) (PDF)
9.5       Facility and Device Security (MS WORD) (PDF)
9.6       Transmission Security (MS WORD) (PDF)
9.7       Contingency Planning
(MS WORD) (PDF)
9.8       Data Integrity
 (MS WORD) (PDF)
9.9       Person or Entity Authentication (MS WORD) (PDF)
9.10     Device and Media Controls
(MS WORD) (PDF)
9.11     Portable Media Security (MS WORD) (PDF)
9.12     Secure E-Mail Transmission
(MS WORD) (PDF)
9.13     Security of ePHI on Home Computers (MS WORD) (PDF)

   
 
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