HIPAA Information

Documents/Forms

HIPAA and Your Privacy Rights

Appendix A
Notice of Privacy Practices (English)
Notice of Privacy Practices (Versión en Español)

Appendix B - Forms
Authorization of Disclosure of Information W-298
Authorization of Disclosure of Information (Versión en Español) W-298s

Request for Access to Protected Health Information.

Request for Amend Protected Health Information.

Request to Restrict Use/Disclosure of Protected Health Information.

Breach Reporting of PII or PHI W-1701.pdf

Breach Risk Assessment W-1702.pdf

Breach ResolutionW-1703.pdf

Appendix C
Guidance Specifying the Technologies and Methodologies that Render Protected Health Information Unusable, Unreadable, or Indecipherable to Unauthorized Individuals.

Appendix D

HIPAA Privacy, Security and Breach Notification Rules.

Appendix E

State Confidentiality Statutes

Responsibilities Disclosure UPM

Appendix F

SNAP ConfidentialityRegulations

Medicaid Confidentiality Regulations