$38.99/Pack$0.19/Each

Usually Ships in 2 Business Days from manufacturer

Lead times vary based on manufacturer stock

Product Overview

  • Required to be given to patients under HIPAA law
  • Attorney approved for ensured HIPAA compliancy
  • Gives patient written notice of PHI disclosure policies and ensures legal acknowledgment of those policies
  • Standard 8 1/2" x 11 size for easy filing
  • Promotes safety and compliancy in medical settings
UPC Code:400015410472

ComplyRight A1354 Specs

Quantity
200/Pack
Shipping Weight
0.77 lb.
Length
11 Inches
Width
8 1/2 Inches
Features
Made in America
Language
English
Material
Paper
Shape
Rectangle
Type
Medical Services Forms

ComplyRight A1354 Details

Keep your patients informed with this ComplyRight HIPAA patient acknowledgment of receipt of privacy practices form. This form gives patients a written notice of PHI disclosure and privacy policies and ensures legal acknowledgment of those policies. This patient acknowledgment is a requirement for all healthcare providers and includes all elements that make the acknowledgment valid, satisfying your HIPAA obligations with documented compliance.

This form should be handed out to patients before, during, or after visits. It is attorney approved, ensuring that it is up-to-date and legally compliant. Plus, at 8 1/2" x 11" in size, it can be easily stored in standard file cabinets for quick reference.

Overall Dimensions:
Length: 11"
Width: 8 1/2"

Because this item is not stocked in our warehouse, processing, transit times and stock availability will vary. If you need your items by a certain date, please contact us prior to placing your order. Expedited shipping availability may vary. We cannot guarantee that this item can be cancelled off of the order or returned once it is placed.

Attention CA Residents:
  • Made in America

    Made in America

    This item was made in the United States of America.

Questions & Answers

Looking For Specific Info? Get quick answers to product questions with our AI-powered search.

Ask about this product

Resources for
ComplyRight A1354

Leave a review of this product!

If you’ve used this product, leave a review to tell us and other customers what you thought about it. Receive up to $16 in promotional credits for submitting one of the first text, photo, or video reviews for this item.

  • Write a text review
    Earn $2.00
  • Post a product photo
    Earn $4.00
  • Post a product video
    Earn $10.00
Review this product
Product Rating (required)

Did this product satisfy your needs?

Add a photo or video

Accepted file types: .jpg, .png, .mpg, mpeg, mov, avi, wmv, mp4 (max file size: 25MB for photos and 300MB for videos)


This form is protected by reCAPTCHA and the Google
Privacy Policy and Terms of Service apply.