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Table of Contents
Clinical records: protected or not
Appendix A: bylaws for an IPA
Appendix B: partnership agreement
Appendix C: articles of incorporation: professional corporation
Appendix D: articles of incorporation: general corporation
Appendix E: certificate of formation of a professional limited liability company
Appendix F: professional limited liability company member agreement
Appendix G: sample business associate contract
Appendix H: business associate contract (attorney services)
Appendix I: authorization for the use and disclosure of protected health information
Appendix J: client information amendment form
Appendix K: notice of privacy practices of Susan A. Jones, LPC
Appendix L: accounting of disclosures of protected health information
Appendix M: request for accounting of protected health information disclosures
Appendix N: authorization revocation form.
Appendix A: bylaws for an IPA
Appendix B: partnership agreement
Appendix C: articles of incorporation: professional corporation
Appendix D: articles of incorporation: general corporation
Appendix E: certificate of formation of a professional limited liability company
Appendix F: professional limited liability company member agreement
Appendix G: sample business associate contract
Appendix H: business associate contract (attorney services)
Appendix I: authorization for the use and disclosure of protected health information
Appendix J: client information amendment form
Appendix K: notice of privacy practices of Susan A. Jones, LPC
Appendix L: accounting of disclosures of protected health information
Appendix M: request for accounting of protected health information disclosures
Appendix N: authorization revocation form.