HIPAA Student or Visitor Training

This form is for HIPAA training intended for Health Care Professionals outside of UAMS.

You must complete the Confirmation Form below to receive credit and for your training record. Failure to do so will result in you not receiving credit for your HIPAA Required Privacy and Security Training. *Indicates a required field, failure to include the information will result in a delay of your training credit.

Please fill out this form and click Submit button below to generate Completion record.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Name *

First Last

Visiting Student Institution (If applicable):

Academic Visitor Institution: (If applicable)

Assigned UAMS Department:

Phone number *

Enter your phone number

Email (Enter your email address) *