Hipaa Training Acknowledgment Form

HIPAA T

RAINING

CKNOWLEDGMENT

I acknowledge that I have viewed the "HIPAA: Mission Confidential" video as

part of my employee orientation process.

I understand that I must comply with the requirements of the Health Insurance Portability

and Accountability Act (HIPAA) of 1996 as presented in the video. It is my

responsibility to ensure that protected health information I have access to is kept private

and confidential.

I understand that failure to abide by the Society’s HIPAA policies and procedures can

result in corrective action up to and including termination of employment.

_________________________________

Print Employee’s Name Here

_________________________________

Employee Signature

_________________________________

Date

0 votes

Parent category: Medical