HIPAA Confidentiality Agreement

About this template

A HIPAA confidentiality agreement is a contract between parties where one, usually a healthcare facility, intends to make sure that its personnel, employees, and staff have full knowledge and responsibility in using and securing the sensitive and medical information of its patients in compliance to the required rules and standards set by the Health Insurance Portability and Accountability Act (HIPAA). Create an online HIPAA Confidentiality Agreement in seconds with Jotform Sign — then securely gather e-signatures from any device.

Need to make changes to this HIPAA Confidentiality Agreement? No problem! Using Jotform’s intuitive online builder, you can easily add your medical practice’s logo, change fonts and colors, add or edit form fields, and more. Share your custom agreement with patients via email or by embedding it in your website. Once both parties have signed, a finalized PDF document will be sent to your inbox — ready to share, download, and print for your records.

Related templates

Maintenance Agreement Template

Create a maintenance agreement between two parties. Great for landlords and tenants. Easy to customize. Works on any device. Go paperless and automate your workflow.

Simple One Page Lease Agreement Template

Let tenants sign your property lease agreements with Jotform Sign. Great for landlords or real estate agents. Fill out and sign in seconds. Easy to customize.

Freelance Contract Template

Hire your next freelance contractor seamlessly with Jotform Sign. Works on any desktop, tablet, or mobile device. Drag and drop to customize. Share or embed.

Payment Agreement Template

Lending or borrowing money? Make sure your terms are clear and fit your needs by using Jotform’s payment agreement template.

Sales Agreement Template

Create a sales agreement contract in seconds.. Collect and manage signatures from one convenient place. Easy to customize. No coding needed.

Interview Consent Agreement

Gather interview consent forms online. Can be filled out and signed on any device. Converts to a PDF instantly. Easy drag-and-drop customization.

The e-sign templates here are for informational purposes only. Jotform is not providing legal, financial, or other advice, or implying that the forms are legally valid in all or any jurisdictions. Before using any such template, consult an attorney and/or other applicable professionals to make sure that the form meets your needs, legally and otherwise.