PHI Tracking Log – 110 form
The use of the PHI Tracking Log will eliminate the need to look through the entire record to determine if the patient has exercised any privacy rights.
PHI Tracking Log – 110 Form available. 100 sheets to a package – Sold by the package.
PHI Tracking Log – 110 Form
HIPAA Form #110
This comprehensive log allows the practice to track the status of each request the patient may have made. It summarizes all forms that will be completed by the patient that are filed in the medical record: Request to Inspect/Copy, Request for Restrictions, Request for Confidential Communication, Request for Amendment, and Request for Accounting of Disclosures. All information is on this one form.
|Dimensions||12 x 8 x 1 in|