HIPAA Forms and Other Private Practice Paperwork

Learn what HIPAA forms your private practice needs and why. Read about all the essential legal and private practice paperwork with Healthie.

Putting the right legal paperwork in order for your wellness business is an important step when launching your business. This paperwork serves as a way to protect your business, your clients and yourself from any misunderstandings or damages. Here, we’ve included a list of the five most important private practice legal forms and other private practice paperwork to create when starting your business, and our best practices for collecting client signatures.  

Business Legal Forms and HIPAA Forms for Private Practice

HIPAA Notice of Privacy Practice Form

The Privacy Rule within HIPAA requires healthcare practitioners to create and distribute a privacy notice that provides a “clear, user-friendly explanation of individuals’ rights with respect to their personal health information and the privacy practices of health plans and health care providers.” More simply, this HIPAA privacy authorization form states how private health information (PHI) may be used or shared so that your clients are aware of their protection and what rights are available to them. It explicitly lets your client know that you will not share their private information without their informed approval.

In your notice, you must disclose:

  • How you will use and disclose a client’s PHI
  • Your client’s rights with respect to their PHI, and how they may exercise these rights
  • Your legal duties with respect to the PHI, including a statement that you are required by law to maintain the privacy of their PHI
  • Who clients can contact for more information 

Procedures for providing the notice include:

  • You must make the notice available to anyone who asks for it
  • If you have a website, you must post and make available the notice there
  • Provide the notice at the start of treatment and obtain the individual’s written acknowledgement that they received the notice

The Department of Health and Human Services (HHS), who governs HIPAA and its regulations, has a plethora of information on creating proper NPPs on their website. At Healthie, we provide a standard HIPAA form for private practice that providers can add to their digital intake forms to be signed by their clients that is accessible within your forms library.

Sign up for a Free Starter Account with Healthie to get access to this feature and many more!

Information Release Authorization form

HIPAA also prohibits healthcare providers to disclose any client PHI unless they have written consent from their clients. An Information Release Authorization form is a great form to include in your intake flow, so that you can obtain (or not) their consent to disclose PHI. The HIPAA Information Release Authorization Form allows you to connect directly with other healthcare providers your client is working with. This form functions as a list of all individuals with whom your client allows you to share their private health information. This form typically includes doctors, therapists, and other health care specialists, but can also include parents, guardians, and other family members.

When writing your HIPAA Information Release Authorization Form, you may not combine it with any other form or document. It must be a stand-alone form that focuses solely on the information release policies and procedures. 

You must include the following in your authorization:

  • A description of what health information will be used or disclosed
  • The name or identification of who will receive the information
  • An expiration date for the release
  • In the case that the PHI will be used for marketing or sales purposes, the provider must disclose this and state they will receive payment in this situation

The HIPAA Release Authorization must be completed in full, written in plain language, signed by the client, and a copy must be retained. 

Statement of Financial Responsibility

A Statement of Financial Responsibility is a signed statement that holds your client accountable for paying for your services. It makes your clients aware of what you expect from them and what they expect from you, financially. Having clients sign this form right away avoids any instances where patients are surprised regarding their financial obligations after receiving your services. And, if a client fails to pay you, it can offer you some level of legal protection. 

When crafting your Statement of Financial Responsibility, be sure to include:

  • When payments are due, i.e. at the time of service
  • Who is responsible for payments
  • How copays and deductibles are handled 
  • What forms of payment you accept, i.e. cash, checks, credit/debit/FSA/HSA cards
  • Policies for failing to pay

When you have a client sign the Statement of Financial Responsibility form, you can also ask them for their credit card information to keep on file, further instilling the importance of these policies in your patients. 

Cancellation Policy 

A  cancellation policy is imperative private practice paperwork that reinforces to clients that your time is valuable. Without it, clients are free to cancel appointments at their convenience — leaving the door wide open for last minute cancellations. For your practice, this means lost revenue. Over time, last minute cancellations add up and can cost you a significant amount of time and revenue.

Cancellation policies are often simple and to the point. The essentials you’ll want to include are:

  • the window of time in which your client can no longer cancel,
  • the fee for canceling too late, not showing up, or coming late to an appointment.

Be sure to let your client know the penalties. We always say post it clearly, introduce it right away, and don’t be afraid to enforce it! If you charge a fee for breaching policy guidelines, be sure to keep a credit card on file. This lets you easily follow through on your policy in your client’s absence. Some additions you may want to include in this private practice paperwork  are “first-offender forgiveness” or a different fee if they reschedule their appointment.

Most importantly, although many practitioners have a cancellation policy in place, they may not enforce it. If a client has signed your cancellation policy and has failed to give the proper notice (ie. 24 hours in advance) then you have the right to enforce your policy.

Pro tip: With a Healthie account, you can customize our standard cancellation policy to your client’s intake flow and obtain an e-signature. This way clients are aware of your cancellation policy before they even have their initial nutrition consultation. To access this feature and many others, sign up for Healthie’s free starter plan.

Testimonial Release 

If you had a particularly good relationship with a client, you may want to ask them to write a testimonial. Testimonials are a great marketing tool. It’s important for your clients to authorize the release of their testimonial. Always get it in writing. In addition, clients need to authorize the release of anything else you may use, like their name or photos.

You may not use your testimonial release form with every client, however, if you’d like to obtain testimonials from your clients (and we highly suggest that you do!), we recommend having a testimonial release waiver ready to go in your private practice paperwork arsenal. 

Building Forms and Obtaining Client Signatures

Intake forms are a crucial part of private practice paperwork and an important step in the onboarding process of new clients within your wellness business. They give you the opportunity to collect crucial health information from new clients so you can create a plan for working together. ⁠ However, collecting this information can be time-consuming and takes away from building a relationship when beginning to work with a client.  Automating your intake process, by leveraging a practice management platform that will send electronic forms when clients sign up, saves time for both you and your clients.  Clients can easily fill their forms out online, where the information will automatically be loaded into your EHR and ready for use.  

With Healthie, you can:

  • Build custom intake forms
  • Create intake flows to send to clients upon creating their Healthie account
  • Have clients fill out and sign the necessary legal forms 
  • Store forms within their Healthie account for easy access

Click here to start your free trial today.

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