| Management number | 234203446 | Release Date | 2026/06/27 | List Price | US$18.16 | Model Number | 234203446 | ||
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The HIPAA Patient Ack. of Receipt of Notice of Privacy Practices form by ComplyRight shows the patient has received a Notice of Privacy Practices form from his or her healthcare provider. It helps to keep signed statements on record that acknowledge that patients received and reviewed the given Notice of Privacy Practices by the healthcare provider, as required by law. This attorney-approved form acknowledges the patient's information to be released to an authorized third party. It meets all required elements for a valid patient acknowledgment under HIPAA and comes in a pack of 200 forms for easily handing out to patients. It measures 8-1/2” x 11” each.
| ASIN | B01J64A6F4 |
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| Brand | ComplyRight |
| Item Weight | 15.2 ounces |
| Manufacturer | ComplyRight |
| Material Type | Paper |
| Number of Items | 1 |
| Item model number | A1354AMZ |
| Product Dimensions | 12.5 x 9.5 x 1 inches |
| Manufacturer Part Number | A1354AMZ |
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