Notice of Privacy Practices (template)
A starting template each practice can adapt and publish to its patients. Version 2026-09-26.
About this template
HIPAA requires each covered provider to give patients a Notice of Privacy Practices. This template is provided for practices using DARO. The practice must review it with its own counsel, fill in its details, and publish it. DARO does not issue this notice on a practice's behalf.
Your information, your rights
You have the right to get a copy of your health record, ask us to correct it, request confidential communications, ask us to limit what we use or share, get a list of those with whom we have shared your information, get a copy of this notice, choose someone to act for you, and file a complaint if you believe your rights were violated.
How we use and share your information
We use and share your information to treat you, run our practice, bill for services, and as required or permitted by law, including public health and safety, research under safeguards, legal requests, and workers' compensation. We never sell your information or use it for marketing without your written permission.
Our responsibilities
We are required by law to protect your information, to tell you promptly if a breach occurs that may have compromised it, and to follow the duties described in this notice.