HIPAA Compliance Training Acknowledgment Form

I acknowledge that I attended, or viewed and listened to a recording of, the HIPAA Training presented by Council for Relationships in November 2022. I understand that I must comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. I acknowledge I have received training in the appropriate uses and disclosures of protected health information (PHI) as they relate to my role as a staff member at Council for Relationships. I understand the PHI of any Council for Relationships clients to which I may have access during the course of my employment is for treatment, payment and health care operations only. I agree to keep any PHI confidential forever and shall not use or disclose PHI unless authorized or required by law.

I understand failure to abide by HIPAA laws and regulations may result in corrective action up to and including termination.

HIPAA Training Acknowledgement*

I acknowledge that I attended, or viewed and listened to a recording of, the HIPAA Training presented by Council for Relationships in November 2022. I understand that I must comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. I acknowledge I have received training in the appropriate uses and disclosures of protected health information (PHI) as they relate to my role as a staff member at Council for Relationships. I understand the PHI of any Council for Relationships clients to which I may have access during the course of my employment is for treatment, payment and health care operations only. I agree to keep any PHI confidential forever and shall not use or disclose PHI unless authorized or required by law.

I understand failure to abide by HIPAA laws and regulations may result in corrective action up to and including termination.

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HIPAA Compliance Training Acknowledgment Form