WE can help with your HIPAA Program needs! The HIPAA Survival Kit: Self-guided workbook, training CDs and video link, Plus document CD and links from which you can customize the required Policies, Risk Analysis, ISAR, Contingency Plans and other components of a HIPAA program. With these tools, you can Do-It-Yourself! Silver: We gather details about your practice using two very straight forward questionnaires, then author all of the required documents for you and deliver you final copies in electronic and hard copy. This is often a 500 to 700 page completed HIPAA compliance manual! We do it for you! Silver Boot Camp: With this Super-Charged Silver Program, you receive everything in the Survival Kit and Silver program plus we come on site and train your compliance officer face-to-face. We assist with fully implementing your HIPAA program, train your staff in person, complete a physical plant walk through/inspection and Certify your Compliance Officer.

*SeveralRequirementsforaHIPAAprogram;• Annual Audit Schedule,

• Physical Plant Audit • Compliance Officer Documents • Complaint Resolution • Updated Notice of Patient Privacy

Policy & Acknowledgements per Omnibus Rules

• Required Forms • Required Audits

*Confidentiality Statements *Business Associate Confidentiality Contracts

• Staff In-Service

• Required Risk Analysis • Required Annual compliance

program review / evaluation • Information Systems Activity

Review • Security Rules In-Service &

Outline • Required Policies and Procedures

for Security Rules (Avg. 80-100 pgs.)

• Contingency Plan with Data Recovery & Emergency Mode Operation

One way or another, You HAVE to HAVE a Customized, Active and Dynamic

HIPAA Manual & Program – By Law!Andbytheway,WashingtonDCsays;NoRiskAnalysis+ISAR

(InformationSystemsActivityReview)=NoProgramatall=$50kFines

When did you do your last ISAR?

©HIPAA Compliance Services PH: 214.437.7559 F: 214.594.0217

Doctor’s Name Clinic Name Phone Number

Email

Credit Card Number Exp. Date Security Code (4Digit Amex)

Billing Address City State Zip Code

Authorized Signature (I accept the charges to my credit card as stated) Date

___ Please ship my HIPAA Survival Kit -->> I want to build my own customized HIPAA manual

- I did NOT receive it at the seminar! *Shipping Address IF different from above City State Zip Code

___ Upgrade! I want the Silver HIPAA Program -->> I want YOU to Pay in Full Discount - save $100!! build my HIPAA

* Event Special – Spread payments over FOUR months of $449 ea. manual Bill my credit card for the First payment of $449. I agree this will be followed And provide a schedule for my ongoing by three additional payments of $449 each and I will receive a document program needs regarding disclaimers, terms and conditions that outlines all details.

___YES! I want to Super-Charge my -->> I want YOU to train my Silver HIPAA Program Compliance Officer

* Please Add HIPAA Boot Camp to my Silver Program Face to Face And increase my monthly payment to $948 per month -In addition to assisting with fully Implementing For FOUR months + Travel Expenses my HIPAA program, complete my Physical Plant

Inspection, and Certify my Compliance Officer! Not Sure About An Upgrade?

Call me to give more info about an upgrade

Order Form Save money when you purchase the HIPAA Survival Kit at the event for the discounted price of - $397.00 (Retail $549.00) + TAX in Texas

OIG Compliance Program FREE with purchase of any HIPAA product (Order form must be received at live event to be eligible for FREE OIG Program = $399 Retail Value)