HIPAA Privacy Compliance Manual: List Of Exhibits

Exhibit 1
Privacy Officer Job Responsibilities

Exhibit 2
Internal Privacy Checklist

Exhibit 3
Notice Of Privacy Practices

Exhibit 4
Sample Privacy Policies

Exhibit 4A
Sample Privacy Procedures

Exhibit 5
Patient Consent for Use and Disclosure of Protected Health Information (2-page PDF file; About PDFs)

Exhibit 6
Patient Authorization for Practice to Release Protected Health Information to Third Parties

Exhibit 6A
Patient Authorization for Use and Disclosure of Protected Health Information for Purposes Requested by the Practice

Exhibit 7
Illustrations of Situations Requiring/Not Requiring Authorization

Exhibit 8
Request For Limitations and Restrictions of Protected Health Information (1-page PDF file; About PDFs)

Exhibit 9
Request to Inspect and Copy Protected Health Information

Exhibit 10
Patient Denial Letter

Exhibit 11
Request for Correction/Amendment of Protected Health Information

Exhibit 12
Request for an Accounting of Certain Disclosures of Protected Health Information for Non-TPO Purposes

Exhibit 13
Log to Track Disclosures of PHI

Exhibit 14
Patient Complaint Form

Exhibit 15
Listing of Typical Business Associates

Exhibit 16
A Medical Practice Guide for the Privacy Officer to Identify Business Associates

Exhibit 17
Business Associate Contract

Exhibit 18
Privacy Policy Training Checklist

Exhibit 19
Training Documentation Form

Exhibit 20
Workforce Confidentiality Agreement

Exhibit 21
Privacy Officer's Incident Event Log