Ambient AI Scribe
Policy Template
A ready-to-adapt policy, patient notice, and consent script for ambient AI scribes and other AI medical scribes that record patient visits to draft clinical notes.
- 27 pages · PDF
- 15 policy sections
- 6 ready-to-use resources
- 1 go-live checklist
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Download the PDFReminder: this sample is general information, not legal or compliance advice. Adapt it to your organization and have it reviewed by qualified legal counsel before adoption or use.
Look inside the AI scribe policy template
Four of the 27 pages. Bracketed, highlighted fields mark what your organization fills in.
Also included: patient notice and acknowledgment form · EHR and platform controls · vendor contract controls · setting-specific guidance · clinician quick-reference card
“Before we start, I use an AI note-taking tool that records our conversation and uses it to prepare a summary for my visit note. I review and validate everything before it goes in your health record. [The audio is deleted once the transcript is created / within X hours after I sign the note.] You can ask me to pause or stop at any time, and it's completely fine to say no.”
From Resource B · Sample point-of-care consent conversation guideSee it in 30 seconds
How the three parts of the template fit together: the implementation guide, the sample policy, and the six resources your teams use day to day.
Read the video transcript
Rolling out an ambient AI scribe? Start with a policy, not a blank page. Meet the free Ambient AI Scribe Policy Template from AITPRM Health. Part one gives you five steps to adopt the policy and launch the tool. Part two is a sample policy with fifteen sections ready to adapt. Part three adds six resources, including a patient notice and a consent conversation guide. Download it free at aitprmhealth.com.
How the template was built
A working starting point drawn from the rules that govern recording, privacy, and AI in patient care.
- Sources
- HIPAA Privacy and Security Rules, the federal Wiretap Act, 42 CFR Part 2, and a sample of state recording, biometric privacy, and AI disclosure laws
- Prepared
- October 2026 · Version 1.0
- Care settings
- Physician practices and clinics, health systems and hospitals, home health and hospice, post-acute and long-term care, and behavioral health
- Written for
- Compliance, privacy, clinical, legal, and health IT leaders
- Format
- 27-page PDF with bracketed, highlighted fields to complete
- Use
- General information to adapt with your own counsel. It is not legal advice and is not a complete survey of federal, state, or local law.
AI scribe policy questions
What is an ambient AI scribe policy?
An ambient AI scribe policy sets the rules for AI tools that record patient visits and turn the conversation into a draft clinical note. It covers when consent is needed, who reviews the AI-generated note, how audio and transcripts are stored and deleted, and who is responsible for monitoring the tool.
What's included in the template?
The 27-page PDF has three parts: an implementation guide with five steps to adopt the policy and launch the tool, a sample policy with fifteen sections, and six resources, including a sample patient notice, a point-of-care consent conversation guide, EHR and platform configuration controls, and contract controls for your vendor. It ends with a go-live readiness checklist.
Do patients have to consent to an AI scribe?
Recording laws vary by state, and some require consent from everyone in the conversation. The sample policy takes the safest approach: consent from every person present before recording begins. Resource B gives clinicians a short consent script, plus what to do when someone declines, hesitates, or joins mid-visit.
Is there an AI scribe patient consent form?
Yes. Resource A includes a sample patient notice and an optional patient acknowledgment form, with a standing consent option for legal representatives. A signed form does not replace asking for consent at each visit.
Are AI medical scribes HIPAA compliant?
No tool is HIPAA compliant on its own. Audio, transcripts, and AI-generated notes are protected health information, so your organization needs a business associate agreement with the vendor and the right safeguards. A business associate agreement is not consent to record. The template's contract controls list what to ask your vendor for.
Who should use this template?
Compliance, privacy, clinical, legal, and health IT leaders at organizations that are piloting or expanding an ambient AI scribe or other AI tool that captures audio during patient encounters.
Is the template free?
Yes. Enter your name, work email, and organization above and the PDF downloads right away.
Can we adopt the template as written?
No. It is a sample for adaptation. Bracketed, highlighted fields mark what you need to complete, and the template is general information, not legal advice. Review it with your legal counsel before adoption.
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27 pages. Free. Ready to adapt.
Download the template →General information only, not legal advice. Review with qualified legal counsel before adoption.