Our HIPAA04 Privacy Notice Acknowledgement Forms come hole-punched for conveniently securing your forms in any file folder of your choosing. These HIPAA forms are also 2 part, providing you with a duplicate copy of your written acknowledgment form every time – perfect for record-keeping and tracking all your privacy notice receipts.

If you would like this form personalized, please select 1/0 in the "Personalization" option group and provide the information that you would like to appear in an artwork file or in the notes section. If "None" is selected in this option group, it will come in its stock form.

Notable Form Features:
- Hole-punched
- 2 part
- Printed on a half-page (8.5" x 5.5")
- Stock or Personalized