HIPAA Confidentiality Agreement
A HIPAA confidentiality agreement is a contract between parties where one, usually a healthcare facility, intends to make sure that its personnel, employees, and staff have full knowledge and responsibility in using and securing the sensitive and medical information of its patients in compliance to the required rules and standards set by the Health Insurance Portability and Accountability Act (HIPAA). Create an online HIPAA Confidentiality Agreement in seconds with Jotform Sign — then securely gather e-signatures from any device.
Need to make changes to this HIPAA Confidentiality Agreement? No problem! Using Jotform’s intuitive online builder, you can easily add your medical practice’s logo, change fonts and colors, add or edit form fields, and more. Share your custom agreement with patients via email or by embedding it in your website. Once both parties have signed, a finalized PDF document will be sent to your inbox — ready to share, download, and print for your records.
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These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.