10 Free HIPAA Compliant Forms

HIPAA Privacy Risk Analysis Checklist

This HIPAA Privacy Risk Analysis Checklist can be used to assess if an organization follows HIPAA’s privacy and security rules by identifying vulnerabilities and weaknesses on the following areas:

• Check-in procedures
• Clinical areas
• Front office and business office
• Medical records
• Methods of conveying PHI
• Personnel policies
• Other general areas

HIPAA Risk Assessment Template

A HIPAA Risk Assessment Template is used for identifying threats and vulnerabilities in the organization that can put Protected Health Information (PHI), sometimes also referred to as Personal Health Information, at risk. This template enables privacy compliance officers to:

• Observe current practices among staff and record how PHI is handled
• Evaluate threats and vulnerabilities discovered during observation by assigning
• Take or attach photo evidence of non-compliance
• Assign actions
• Generate assessment reports
• Identify the next steps to be able to comply with HIPAA regulations

HIPAA Annual Risk Analysis

Use this checklist as a guide for annually evaluating devices in the organization to prevent data breaches. Questions covered in this HIPAA Annual Risk Analysis include:

• Working condition
• Signs of damage
• Password storage & location
• PHI security

HIPAA – 45 CFR Part 164 Security & Privacy Assessment Checklist

This HIPAA security checklist is used for evaluating an organization’s compliance with
HIPAA’s privacy rule 45 CFR Part 164.
This checklist includes 7 parts, which are:

1. Security management process
2. Assigned security responsibility
3. Workforce security
4. Information access management
5. Security awareness and training
6. Security incident procedures
7. Contingency plan

HIPAA General Privacy Risk Analysis Checklist

Use this template to check how PHI and other information is generally handled in your institution. With this ready-to-use checklist, you can do the following:

• Conduct regular internal audits to reinforce best practices and call out gaps
• Review the check-in procedures including the New Patient Information
• Assess the clinical areas, offices, and status of medical records, as well as the methods of conveying PHI

Clinical Laboratory HIPAA Privacy Risk Analysis Checklist

This pre-existing template from the Thomas Jefferson University Hospitals can be used by organizations as a guide in making sure that they are compliant to the HIPAA policies and regulations. One of the main things that this checklist review is the organization’s rules in disposing and retention of protected health information of patients.

Pharmacy Unit Inspections Checklist

This general pharmacy inspection template is focused on patient care areas and how a medical institution complies with the rules surrounding them. Aside from making sure that their medications are HIPAA compliant, this checklist also evaluates the following items:

• Drug control and storage
• Controlled drugs
• Emergency medications
• Pyxis
• Pharmacy Tasks

Area Risk Assessment Checklist

Medical institutions and other related industries can use this general risk assessment checklist to assess the level of risks associated with various aspects of their business operations. With this ready-to-use template, users can categorize the risks found as very low, low, moderate, or high, and prioritize them accordingly. Items include exposure to needles, sharp objects, tuberculosis, chemical, lasers, body fluid, and x-rays, as well as compliance with HIPAA procedures.

Client Intake and Eligibility Form Checklist

Use this checklist to securely document and communicate information such as:

• Client’s name, birth date, social security number, etc
• Client’s parent, legal guardians, or authorized representative
• Client’s rights and responsibilities
• Agreement on confidentiality (particularly HIPAA)
• Service options
• Acknowledgement