Patient Confidentiality Agreement
Give your patients peace of mind that their sensitive medical data is safe with this Patient Confidentiality Agreement. Simply customize this template however you see fit, then share your form via email. Patients can then fill out this agreement form from any smartphone, tablet, or desktop computer. You’ll receive an email notification and a signed and finalized version of the document in your online dashboard.
Make changes to this Patient Confidentiality Agreement with our drag-and-drop builder. Change the agreement terms, add new text boxes or signature fields, upload your clinic’s logo, choose fonts and colors, and much more without any coding knowledge. Once a patient fills out and signs your document, you can instantly print and download it as a PDF document for your records. Say goodbye to messy paperwork and keep everything safe and secure with Jotform Sign.
Doctors Note Template
Create a doctor’s note for your medical practice. Sign and send to your patients. Works on mobile, tablet, and desktop devices. Drag and drop to design.
Power of Attorney Form
Create a professional power of attorney form. Signable on any smartphone, tablet, or desktop. Easy to customize and share with others. Converts to PDF.
Rent Ledger Template
Create a rent ledger agreement in seconds. Fill out and e-sign from any smartphone, tablet, or desktop. Easy to customize and share. Converts to a PDF.
HIPAA Release Form Template
HIPAA (Health Insurance Portability and Accountability Act), also known as Public Law 104-191, is a law passed in the United States that protects and safeguards the privacy of medical information and has two main purposes: First, to provide continuous health insurance coverage to workers who switch jobs or lose their jobs; Second, is to standardize the electronic transmission and transactions for security and protection of information. This law was primarily passed due to proliferation of data breaches concerning health information.This HIPAA Release Form PDF Template is a standard release authorization form for disclosure of health information for healthcare and health insurance providers which the subject or person consents on disclosing his health information to a certain healthcare organization. This HIPAA Release Form PDF Template is easy to modify and flexible to use.
Online Therapy Consent Template
Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.
Professional Medical Release Template
Create a professional medical release template. Great for medical practices and therapists. Collect signatures online. Converts to PDF. Easy to customize and share.
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.