HIPAA Privacy Policy Sample and Other Government Templates for Private Practice
I see constant requests, especially in the therapist Facebook forums, for samples of people’s HIPAA Privacy Policy, etc.
The great news, is the federal government has created a number of privacy policy samples and other key documents that clinicians spend too much time and money trying to create on their own.
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You should also check out Termageddon for a cheap automated option to keep your website policies updated, as well as Accessibe to get a free audit of your website’s ADA accessability.
You can see our full spreadsheet of recommended software and solutions that we use in our practice and/or are favorites of our coaching clients.
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Informed Consent Guidance from HHS.gov
HIPAA Release of Information sample – From HHS.gov – Updated May 2024
HIPAA Model Privacy Policy (w/ Instructions) – From HHS.gov – Updated Feb 2026
HIPAA CFR 42 (Part 2) Notice Template – From HHS.gov – Updated Feb 2026
Good Faith Estimate Sample from CMS / Medicare – Update Aug 2023
Notice of Right to Receive a Good Faith Estimate – CMS / Medicare – Updated Aug 2023
Sliding Scale Policy Sample (with scale example on page 7) – National Health Service Corps
Federal Poverty Guidelines (used to set your sliding scale levels) – HHS.gov – Updated for 2026
Business Associate Agreement Sample – from HHS.gov
Notice of Non-discrimination and Accessibility for practices receiving Federal funds – If Section 1557 entity
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