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
Distribute Form After Each Training Session:
Ensure that all employees sign the form immediately after completing the training.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).Retention:
Retain all completed forms securely for six years as part of compliance records.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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