Updated for the HIPAA Mega Rule! Track all disclosures of individual patient s information, including date, recipient of information, purpose, type of information, and name of employee disclosing. A disclosure key is printed at the bottom for quick reference and standardization.
Briggs offers a complete line of HIPAA documentation. Also see: Notice of Privacy Practices / Acknowledgment of Receipt - Updated! (Stock No. 1770) Business Associate Agreement - Updated!(Stock No. 1771) Request to Review or Obtain Copies of Protected Information (Stock No. 1772) Authorization to Release Patient Information (Stock No. 1773 or 1773/2) Request for Amendment of Information (Stock No. 1775) Denial of Amendment (Stock No. 1776) Disclosure Log - Updated! (Stock No. 1779) Confidential Patient Sign-In Log (Stock No. 1791)
8 1/2" x 11", white paper, printed one side, black ink, 5-hole punched top and side, padded in 100s.
