Clinic Security Policy Templates & Forms – Vancouver Division of Family Practice

Clinic Security Policy Templates & Forms

Privacy and Security Policy Templates

Protecting patient privacy and maintaining strong data security practices are foundational responsibilities in primary care. To support family physicians and clinic teams in Vancouver, we’ve compiled a list of commonly requested policy and form templates from trusted sources including Doctors of BC, the Office of the Information and Privacy Commissioner (OIPC), and the Canadian Medical Protective Association (CMPA).

These resources are designed to help clinics:

Develop or update privacy and confidentiality policies
Respond to privacy breaches appropriately
Meet legal and regulatory requirements
Ensure staff, third parties, and patients understand their roles in protecting patient health information

This list includes a subset of the most commonly used templates. For additional materials, we encourage you to explore the full Doctors of BC Privacy Toolkit and CMPA Risk Management Toolbox.

For Clinic Staff

Clinic Staff Privacy & Security Policy – Doctors of BC, word document

Clinic Staff Confidentiality Agreement – Doctors of BC, word document

Clinic Staff Confidentiality Agreement – CMPA, fillable PDF

Privacy Breach Response (Guidance with templates) – OIPC, PDF

Privacy Breach Online Reporting Form – OIPC, web page

For Third Parties

Confidentiality Agreement – Doctors of BC, word document

Confidentiality and Data Sharing Agreement – Doctors of BC, word document

For Patients

Clinic Patient Privacy & Security Policy – Doctors of BC, word document

Patient Request Form for Access to Personal Information – Doctors of BC, PDF

Patient Request Form to Correct Personal Information – Doctors of BC, PDF

Physician/Clinic Website Terms of Use Template – CMPA, PDF

Consent to Virtual Care – CMPA, PDF

Need Help with Privacy and Security Policies?

Our Tech Concierge team can support your clinic in navigating privacy and data security requirements. Whether you’re drafting new policies or adapting templates to fit your workflow, we’re here to help.

Email concierge@vancouverdivision.com

Book a 1:1 call with our Tech Concierge or attend our Virtual Office Hours