Apply for your office

Applications close September 21, 2026 at 11:59 p.m. Central Time. Selected practices will be notified by September 30, 2026. Please answer accurately — every field helps us match the program to the practices best positioned to complete the curriculum.

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About you

Your full name

Your role at the practice

Phone

We only use this to reach selected practices about activation.

About the practice

Practice or organization name

Practice type

Total personnel (clinicians + staff)

State

City

Practice website (optional)

Training administrator

Every selected office designates one person to manage the training program. Are you that person?

Yes — I will administer the programNo — someone else at the office will

Current training landscape

How does your office currently handle HIPAA training?

Current vendor or platform (optional)

How often does your workforce complete HIPAA training?

How many personnel need training in the next 12 months?

Readiness and reason

How quickly can your office implement if selected?

What best describes why you're applying?

Anything else you want us to know? (optional)

Keep under 800 characters. Please do not include any patient information or protected health information.

How did you hear about this initiative? (optional)

Confirmations

I am at least 18 years old and authorized to submit this application on behalf of the practice.

This is the only application from my organization. Only one application per organization will be considered.

I understand the training-only nature of this initiative, that a payment method will be verified at activation but not charged for included access, and that Patient Protect will not automatically convert my office into a paid subscriber.

Send me occasional practical HIPAA resources from Patient Protect. (Optional. You can unsubscribe any time.)

By submitting, you agree we may contact you about this application. See our privacy policy.