HIPAA Breach Notification Letter

Date:

To:

Subject: Notification of Breach of Protected Health Information

Dear

We are writing to inform you of a recent incident involving your protected health information (PHI). We take the privacy and security of your information very seriously and are committed to keeping you informed.

What Happened

What Information Was Involved

What We Are Doing

What You Can Do

For More Information

If you have any questions or need further assistance, please contact us at:

• Phone:
• Email:
• Address: