Sample binder

This is the binder the wizard generates for a fictional practice, Granite City Family Dental, a dental office with 9 staff in 412 2nd Street South, St. Cloud, MN 56301. Every document below is produced from that practice's answers; yours will read the same way with your names, systems and decisions.

The sample deliberately includes a few gaps (no MFA on the EHR, an unsigned vendor agreement) so you can see how the binder turns a gap into a risk-register item and a line on the remaining-steps checklist.

#	Document
00	Binder cover, index and how to use this binder	View
01	Entity profile and covered-entity / business-associate determination	View
02	Privacy Officer and Security Officer designation letters	View
03	Compliance program charter and annual calendar	View
04	Documentation and record retention policy	View
05	Sanction policy and sanction log	View
06	Notice of Privacy Practices	View
07	Uses and disclosures, minimum necessary and verification policy	View
08	Authorization form; marketing, fundraising and sale of PHI policy	View
09	Patient rights procedures, request forms and logs	View
10	Complaint handling and mitigation policy	View
11	Safeguards for PHI in all forms (paper, oral, fax, mail, text, social media)	View
12	Workforce training policy and roster	View
13	Security risk analysis report and risk management plan	View
14	Workforce security and information access management	View
15	Security awareness, password and authentication policy	View
16	Security incident response plan, ransomware playbook and incident log	View
17	Contingency plan: backup, disaster recovery, emergency mode, testing	View
18	Evaluation and annual review procedure	View
19	Business associate policy, agreement template and register	View
20	Physical safeguards: facility, workstation, device and media controls	View
21	Technical safeguards: access, audit, integrity, authentication, transmission	View
22	Breach notification policy, four-factor worksheet and notice letters	View
23	Minnesota Health Records Act supplement and consent form	View
24	Annual review meeting minutes and attestation	View
25	Registers and logs appendix	View
26	Confidentiality agreement and workforce acknowledgment forms	View
27	Remaining steps and information still needed	View

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