< Back Sample Personnel Documents Practice Management Online features a collection of sample personnel documents that your practice can review to assist in developing personnel materials for your own office. See also Sample Office Documents. Find more Documents & Forms in the Practice Toolbox A Medical Practice Guide for the Security Official to Identify Business Associates That Access PHI This flowchart guide shows a Security Official how to identify business associates who need access to protected health information. Back Office General Procedures This sample document can be used as general procedures for back office staff. Back Office Training Guide This checklist can be used and/or adapted when training back office staff. Business Associate Contract Sample contract to be signed by business associates who may perform a function or activity on behalf of the practice involving the use and/or disclosure of protected health information, one of a collection of documents designed to assist your practice in setting up appropriate policies and procedures to comply with the HIPAA Privacy Rule. Cashier Policies and Procedures This sample document can be used to establish policies and procedures for cashier responsibilities in a practice. Clinician Evaluation and Progress Criteria This sample document may be used to evaluate physician and provider job performance. Contingency Plan Steps Outlines the step-by-step contingency plan for practices to analyze the criticality of their data, backup plan for their data, and the disaster recovery plan, as well as the steps to activate the contingency plan through the response phase, resumption phase, recovery phase, and restorations phase. Curriculum Vitae Builder Simply enter the information into the fields and, once completed, a curriculum vitae will be provided. Employee Evaluation of Physician Performance This sample document can be used to assist practices in asking employees to evaluate physician performance. Facility Maintenance Log This sample facility maintenance log records the date, maintenance issue, who performed the repair, and date of repair. First Amendment to Business Associate Agreement This template is for the practice and contractor to complete, but it does not reflect requirements of state laws and suggests a practice consult with advisors familiar with their state's privacy laws regarding third-party beneficiaries. Front Desk - General Procedures This sample document can be used as general procedures for front office staff. Internal Privacy Checklist Sample checklist to help determine whether your practice's current procedures comply with the HIPAA Privacy Rule, one of a collection of documents designed to assist your practice in setting up appropriate policies and procedures to comply with the HIPAA Privacy Rule. Job Description: Back Office Assistant (Assisting a Practitioner) This sample job description may be used/adapted to fit the needs of your practice. Job Description: Front Office Clerk These sample job descriptions can be used and/or adapted to meet the needs of your practice. Job Description: Laboratory Technician This sample job description may be used/adapted to fit the needs of your practice. Job Description: Licensed Practical Nurse This sample job description may be used/adapted to fit the needs of your practice. Job Description: Medical Assistant This sample job description may be used/adapted to fit the needs of your practice. Job Description: Office Coordinator This sample job description may be used/adapted to fit the needs of your practice. Job Description: Office Lead This sample job description may be used/adapted to fit the needs of your practice. Job Description: Patient Representative/Billing This sample job description may be used/adapted to fit the needs of your practice. Job Description: Patient Scheduler/Appointments These sample job descriptions may be used/adapted to fit the needs of your practice. Job Description: Practice Administrator This sample job description may be used/adapted to fit the needs of your practice. Job Description: Registered Nurse This sample job description may be used/adapted to fit the needs of your practice. Laboratory Testing Personnel Performance Appraisal "This sample document can be used when performing staff performance appraisals for staff on laboratory testing." Management Action Plan This sample document can be used to establish a management action plan for practice employees. Performance Review--Self-Review Form This sample document may be used by employees to evaluate their own job performance. Physician Performance Standards This document outlines the performance standards required when hiring a physician. Privacy Officer Job Responsibilities Sample list of Privacy Officer job responsibilities, one of a collection of documents designed to assist your practice in setting up appropriate policies and procedures to comply with the HIPAA Privacy Rule. Professional Staff Performance Evaluation This sample document can be used when performing staff performance appraisals and includes documents to assist when conducting performance evaluations and performance narratives. Sample Contingency Policy and Procedure This sample policy and procedure establishes contingency plans to protect the confidentiality, integrity, and accessibility of a practice's EPHI from vulnerability in the event of an emergency. Sample Curricula Vitae Use these samples to create your Curricula Vitae or visit CV builder to build your own. Sample Employee Handbook This sample document can be used or modified as an employee manual for your practice. Sample Employment Contract This sample employment contract can be used or adapted to fit the needs of your practice. Sample Policy and Procedures on Workstation Use Sample policy on workstation use to comply with HIPAA, including sections on operating environment, passwords, content, log-off, backup procedures, device and media controls, destruction procedures, sanctions, portable computers, e-mail, internet access, PDA, and remote access. Sample Sanction Policy Sample policy for efficient and professional performance of employees' duties to protect integrity and confidentiality of medical and other sensitive information. Sample Security Incident Log This sample log records information for reporting a security incident: description of the incident, time/date reported, time/date of occurrence, reported by, handled by, practice individuals notified, and details of the response to the incident. Sample Security Incident Policies and Procedures Procedures for individuals within a practice responsible for implementing and adhering to the practice's security incident policies and procedures. Sample Time Off Policies These sample documents can be used as a guideline to create time-off policies for staff. Sample Workforce Termination Procedures Sample checklist of procedures to follow immediately upon an individual's termination from the practice to revoke the individual's access to the physical office and computer system. Security Policy Training Checklist Checklist of tasks to be completed by a practice to ensure compliance with the Security Policy. Staff Evaluations: Guidelines and Instructions This sample office document provides guidelines and instructions for conducting staff evaluations. Staff Evaluations: Template This sample staff evaluation form can be used to assess various staff positions. The document has tabbed sections for evaluating registered nurses, licensed practical nurses, medical assistants, front and back office personnel, office coordinator, administrative assistant, collections personnel, laboratory personnel, and referral coordinators. Training Documentation Form Sample form to be signed by staff and physicians after the completion of training on the practice's privacy policies and procedures, one of a collection of documents designed to assist your practice in setting up appropriate policies and procedures to comply with the HIPAA Privacy Rule. Weekly Office Manager Report This sample document can be used by office managers to report on practice-related issues and goals. Workforce Confidentiality Agreement Sample confidentiality agreement to be signed by staff and physicians requiring them to keep protected health information confidential, one of a collection of documents designed to assist your practice in setting up appropriate policies and procedures to comply with the HIPAA Privacy Rule. Workforce Termination Checklist Checklist of tasks to be completed by a practice to ensure appropriate procedure is followed upon termination of an individual from the practice.