3-Part Notice of Privacy Practices HIPAA Acknowledgment

Item#: PRV1 Size: 8 1/2 x 11"

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Product Benefits and Features

Document your patients' receipt of your privacy policy.

  • Personalization includes: Your imprinted practice name, address, and phone number, up to 5 lines. 3-part form provides copies for patient, chart and privacy officer. 2-hole punched at top.