Free HIPAA Breach Notification
Letter generator

[Date]

[Patient Name] [Patient Address]

Dear [Patient Name],

We are writing to notify you of a data security incident at [Your Organization Name] that may have involved some of your protected health information. We take the privacy and security of your information seriously, and we are providing this notice in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule (45 CFR 164.404).

What Happened

On [date of discovery], [Your Organization Name] became aware of an incident that may have involved some of your protected health information.

What Information Was Involved

The protected health information that may have been involved includes your full name, and medical or clinical information such as diagnoses, treatment, or medical record numbers.

What You Can Do

As a precaution, we recommend that you review statements from your health plan and providers, along with any explanation of benefits, for services you do not recognize, and report anything unfamiliar right away. You may also request a free copy of your credit report and consider placing a fraud alert or a security freeze with the major credit bureaus.

What We Are Doing

We are investigating the incident, have taken steps to secure the information involved, and are reviewing our safeguards and procedures to help prevent something like this from happening again. Where appropriate, we have notified law enforcement and are cooperating with their review.

For More Information

If you have questions or would like more information, please contact [Contact Name] at [toll-free phone number].

We sincerely regret any inconvenience or concern this incident may cause you. Protecting your information is a responsibility we take seriously, and we remain committed to keeping it safe.

Sincerely,

[Name]

[Title], [Your Organization Name]