"HIPAA Hurt Me" Stories


What Happened when You Refused to Sign the "HIPAA Privacy Form"?

Please share your story about refusing to sign the clinic or hospital's HIPAA privacy form. Were you denied treatment? Did they force you to pay cash? Did they argue about it and then let you refuse?
By law, you are allowed to refuse to sign the clinic or hospital "HIPAA Privacy form.” We encourage you to do so. It’s important to exercise this right, and we need as many stories about what happens when patients refuse to sign the form, particularly if you are denied care, made to feel bad, made to miss your appointment or hurt in any other way. Or perhaps you’re a practitioner and your hospital or ACO system is requiring you to deny care to those who exercise their right to refuse. Please share your story.


December 2nd, 2022
First Name  
Last Name - NOT posted or published  
Email - to verify data - NOT posted or published  
Zip Code  
Position (Please select one)  
How HIPAA Hurt Me (Provide Summary in 10 Words or Less)  
Hurt Category  
What Happened: Give Us Your Story in 1000 Words or Less (NOTE: NO names of doctors, clinics, hospitals, etc will be published. We'll delete them if you do not)  


You Have a Right to Refuse to Sign HIPAA Form in any way, shape or form. The federal government (U.S. Department of Health and Human Services) has publicly stated that you have a right to refuse. That includes the right to refuse to sign the form eve after they write “Refused” on it. No signature at all is required.

NOTE: Refusing to sign or choosing to sign provides you with no privacy protection to the 2.2 million entities given access to your data through HIPAA (1996) and HITECH (2009). However, if your data is broadly shared without your consent and you complain, you are protected from clinic staff or lawyers saying that you signed a form that says you know how broadly your data can be shared and thus you should not have shared that confidential data. In essence they will use the form to blame you for sharing information you needed to share but wanted to protect.

If you refuse to sign the HIPAA privacy form, some clinics or doctors or hospitals may incorrectly refuse to provide treatment. If they do so, they are in violation of your HIPAA rights — but probably only because they don’t know you have that right.

Be gentle but firm. You may want to contact us for wallet-size cards to give to them.  The U.S. Department of Health and Human Services has a web page that says you are allowed to refuse.


NOTE:  By pressing "Submit", you are giving CCHF your consent to share your story online and elsewhere.

NOTE ALSO: We will delete before publication any names of any doctors or clinics or hospitals. Nor do we include your last name or address. We'll keep it for our records, but not for public viewing. Finally, your personal information is NOT shared with any third parties.