Privacy and Confidentiality

Use our Practice Plus resources to help you ensure you meet your privacy obligations.

Click a link below to download the resource:

Information

Privacy and practice’s employee records exemption

Forms

Privacy consent form
Patient record disclosure – log sheet
Patient representative’s authority to request records from another practice
Patient authority to request records from another practice
Patient request to access records held at the practice
Patient/guardian authority to transfer records to another practice
Permission to release personal health information
Photographic agreement

Checklists

Practice record checklist
Practice audit checklist
Practice privacy checklist

Letter templates

ISP privacy letter
Letter to current patients re sale/transfer/closure of practice
Letter to dental laboratory requesting commitment to APPs
Letter to other party requesting access to patient information
Letter to other practice seeking access to patient records and requesting patient consent
Letter to service entities requesting commitment to APPs
Response to dental practice releasing patient file – letter template
Response to patient request for file – letter template

Notices

Important information about the practice and your privacy
Notice for patient information
Practice commitment to privacy legislation
Practice notice re sale/transfer/closure of the practice
Practice privacy complaints register
Practice privacy handling framework

Policies and procedures

Practice privacy policy
Practice privacy policy for ongoing contact
Practice privacy position
Practice privacy program
Practice privacy provisions
Privacy complaints process
Privacy audit
Sample privacy warning for fax and email
Telephone protocol to confirm identity of person seeking information
Video surveillance
Website privacy and policy statement

Note: These are member-only resources. You must be logged into the website to download.

Keep all Practice Plus resources at your fingertips

Download the Practice Plus Support Services Manual for the full range of resources all in the one place. Contact us to purchase a hard copy of the manual.