HIPAA Forms for Privacy Rule Compliance




  • Notice of Privacy Practices (NPP) – Must be made available to each patient on the first visit and posted on the practice’s website
  • Acknowledgment Statement – Must be signed by each patient on first visit to prove the provider made a copy of the NPP available to the patient.
  • Authorization to Disclose Protected Health Information (PHI)
  • Consent for Email and Text Message Communication
  • Email Disclaimer for Misdirected Email
  • Consent and Release for Use and Disclosure of Image, Voice, and/or Written Testimonials – includes HIPAA Authorization to Disclose PHI for Media Purposes

Your purchase gives you a non-exclusive license to download one copy of the form one within 10 days of your purchase for your personal use.  Our website Terms of Use applies to all purchases.