Practice Forms & Templates

Essential forms, documents, and templates that every DPC practice needs, organized by category with descriptions, purposes, and requirements.

This page provides general information about forms and documents commonly needed by DPC practices. It is not legal advice. Requirements vary by state and jurisdiction. Always consult with a healthcare attorney, CPA, and compliance professional when setting up your practice documents.

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Practice Forms & Templates

Articles of Incorporation / Organization

Operating Agreement / Bylaws

EIN Application (IRS Form SS-4)

Business License Application

NPI Application (CMS-10114)

DPC Membership Agreement

Informed Consent for Treatment

Telehealth Consent Form

Financial Agreement / Payment Authorization

Minor Patient Consent / Parental Authorization

Notice of Privacy Practices (NPP)

HIPAA Authorization for Release of Information

Business Associate Agreement (BAA)

HIPAA Risk Assessment Documentation

Medicare Opt-Out Affidavit

Medicare Private Contract

Physician Employment Agreement

Employee Handbook / Policy Manual

Independent Contractor Agreement

CLIA Waiver Application (CMS-116)

DEA Registration (Form 224)

State Controlled Substance License

Medical Waste Disposal Agreement

Incident Report / Adverse Event Form

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