Sample Forms and Contracts
for Independent Advocates
Find samples and forms you may use in your practice.
Important!
The Alliance of Professional Health Advocates (APHA) and the APHA Legal Advisor do NOT guarantee that the legal forms posted here are legally sound or representative. They are merely samples, intended to (1) get you thinking about what provisions you would like to include in your own contracts, (2) serve as comparisons to whatever contracts or other legal information your own attorney might provide to you, and (3) help you to become familiar with some legal terminology and various types of clauses (which should in turn make your conversations with your own attorney more productive!)
The contracts you use in your business will be necessarily state- or province-specific because laws vary by location (what works in one state or province won’t necessarily work in another!) The sample contracts contained herein do NOT take into account any variations in states’ laws and may not, therefore, be used as-is.
Do not use ANY sample legal contract posted here “as is.” On the contrary, consult with a business attorney (one who is duly licensed and in good standing in your state) to create and/or review your business contracts.
By downloading and viewing these sample legal forms, you hereby agree to hold harmless both the APHA and the APHA Legal Advisor from any future loss, damage, or legal liability arising from any decision to use these sample contracts, despite our warnings herein.
*See additional Disclaimer below.
• Client Intake and Assessment Form
- Use this questionnaire at the start of a client relationship to help you assess the client’s needs. To prepare ahead of time, download the Word version, then make the changes that fit the client’s circumstance and your approach to advocacy.
editable | pdf
• Consultation Agreements (Contracts)
Use these with both a client and guarantor (the person paying for your services)
These contracts are pdfs, non-editable, and watermarked, provided intentionally as such to be sure you do not use them as-is. See the note above about contracts being state- or province-specific.
Please don’t ask us for an editable copy of any contract – we do not have editable contracts to give you. The attorney who drew them up for us did not give us editable versions precisely so they could not be used as-is.
Download copies of any contracts you think you will use, then take them to your attorney for review. This is the least expensive way to get the contracts you need, tailored to your business, and legal in your state or province. Your attorney will be able to see what specific information needs to be included in a contract for advocacy work, and can then apply those concepts to any standard service business agreement they prefer to use.
- Sample consultation agreement (between advocate and client) Provided by APHA’s Legal Advisor
- Sample Consulting plan
- Sample Payment Guarantee
• HIPAA Forms
- HIPAA Privacy Authorization Form
- HIPAA Privacy – can be filled out and printed on your computer. (Developed for use in NY state, but may be used elsewhere.)
- Protected Health Information Release Authorization editable | pdf (with thanks to Dianne Walkup)
- Protected Health Information Release Authorization for Minor Child editable | pdf (with thanks to Dianne Walkup)
- HIPAA Authorization (with thanks to Rae Drazin)
- CMS Authorization Form
• Independent Contractor Contracts
- Independent Contractor working agreement (for use between the advocate and the independent contractor being hired, includes “non-compete” language)
- Independent Contract Non-compete Addendum (an extra step if you need it. Consult with your attorney.)
• Invoicing Process and Forms
- Overview of Invoicing and Tracking
- Sample Invoice
- Invoice templates: editable
• Sale of Your Practice Process and Forms
- Expert Call-in Describes the Overview
- Form: Non-Disclosure Agreement (NDA)
- Form: Executive Summary Template
* Disclaimer:
The materials and information contained on this site are provided for informational purposes only and are not to be considered as legal advice. The information varies from state to state, and readers of this site should consult with their respective states’ business divisions (Secretary of State) for more state-specific information.
Transmission of the information is not intended to create, and receipt does not constitute, an attorney-client relationship between the sender and receiver.
The Alliance of Professional Health Advocates does not provide any warranties whatsoever with respect to any hyperlinks found throughout this web site. These hyperlinks are offered as a service to our readers.
Visitors to this web site should not act upon any information found on this web site without first seeking professional legal counsel in his or her State and jurisdiction.
Misspellings for Search: HIPPA, HIPA