Hipaa Basic Training Acknowledgement Form printable pdf download

Hipaa Basic Training Acknowledgement Form

Sedgwick County

Health Insurance Portability and Accountability Act

BASIC Training Acknowledgement Form

All Sedgwick County employees will be trained in the Privacy Regulations in accordance

with the Health Insurance Portability and Accountability Act (HIPAA) 45 CFR

Section 164.530 (b). The employee’s role and access to Protected Health Information

within Sedgwick County will be related to the level of training required.

I, the undersigned, hereby acknowledge that I have read and understand the above written

Sedgwick County Basic Training and agree to abide by the HIPAA policies demonstrated

through the training.

I understand this Acknowledgement does not in any way constitute an employment

contract, and Sedgwick County reserves the right to amend this training and dependent

HIPAA policies at any time, without prior notice to me.

_________________________________________

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Employee Name-Printed

Date

_________________________________________

Employee Signature

_________________________________________

Sedgwick County Department

Hipaa Basic Training Acknowledgement Form