FORMS Database:
DPC Frontier Legal Checklist (free to fellow physicians by email request to Dr. Eskew)
State by State Requirements for Professional Entities (Northwest Registered Agent LLC)
LLC Operating Agreement (from a Colorado practice)
DPC Patient Contract (free to fellow physicians by email request to Dr. Eskew)
Physician Employment Agreements
—- Tips for Reviewing Your first Physician Employment Contract (Eskew)
—- A Guide to Understanding and Negotiating a Physician Employment Contract (Kreager)
—- Physician Employment Contract Guide (with sample agreement) (ACP)
—- Physician Employment Agreement Example (Tennessee)
Health Insurance Portability and Accountability Act
HIPAA Risk Assessment - use this HealthIT.gov tool to develop form (update annually)
HIPAA Notice of Privacy Practices (from HHS)
HIPAA Authorization Form (From the Missouri Bar)
HIPAA Consent Form - NOT REQUIRED (See HHS Explanation)
HIPAA Accounting of Disclosures (No "form" only a list - see summaries from Ohio State and Columbia Universities)
Physician Opt Out Affidavit (from AAPS) (send to your Medicare Carrier - they may have their own form as well)
Other Opting Out Forms (from AAPS)
Opting Out Overview (from AAPS)
Opt out Affidavit and Sample Private Patient Contracts (From AAFP)
On Site Clinic (with Large Employer) Agreements: (if the items below look intimidating, consider partnering with Proactive MD!)
From St Johns County School District Contract (simple 12 pager)
From Manatee County Florida Contract (comprehensive file)
From City of Kirkland Example Request for Proposal (must be able to answer these questions)
From Bartlett City Schools Example Request for Proposal (must be able to answer these questions)
From Dallas Independent School District Example Request for Proposal (must be able to answer these questions)
Clinical Laboratory Improvement Act (CLIA) Application for Certification (see additional discussion here)
Occupational Safety and Health Administration (OSHA) - see links, no standard forms and don't pay for a poster!
Please let us know what other areas you would like to see on this page!