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Training Acknowledgment Form

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Written by Drew Salisbury
Updated over 6 months ago

Purpose:

Document workforce completion of HIPAA training under §164.530(b).

Instructions:

  • Collect signed acknowledgment forms after training.

  • Retain forms securely for six years.

  • Audit annually for compliance.

Optional Template:

An acknowledgment form template is available to track training completions.

Purpose:

This form documents that workforce members have completed required HIPAA training, ensuring accountability and compliance with §164.530(b).

Instructions for Use

  1. Distribute Form After Each Training Session:
    Ensure that all employees sign the form immediately after completing the training.

  2. Role-Specific Training Details:
    Include space to document role-specific or scenario-based training (e.g., for responding to emergency disclosures or handling access requests).

  3. Retention:
    Retain all completed forms securely for six years as part of compliance records.

  4. Audit Regularly:
    Include the forms in quarterly documentation audits to verify training completion and compliance.

Training Acknowledgment Form

Field

Description

Employee Name

Name of the workforce member completing the training.

Department

Department or role of the employee (e.g., IT, HR, Clinical Staff).

Training Date

Date the training was completed.

Training Topics Covered

Summary of training topics (e.g., PHI handling, breach notification, individual rights).

Trainer/Facilitator Name

Name of the trainer or facilitator conducting the session.

Employee Signature

Signature of the employee acknowledging completion.

Trainer/Facilitator Signature

Signature of the trainer to confirm delivery of the training.

Comments/Notes

Additional notes (e.g., role-specific training details, follow-up needs).

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