# Privacy Impact Assessment Template, Free Source: https://nerix.ai/templates/privacy-impact-assessment Check a new project that uses personal data: what you collect, the risks to people and how you reduce them. Before you send it Many data protection laws require an assessment for high-risk uses of personal data, and they differ by country. This template is a working structure, not legal advice. Ask your data protection officer or adviser where one is required. ## Fill it in and preview You are signed in. Fill it in your workspace and it is kept as a document you can send, share and have signed. [Open in your workspace](https://app.nerix.ai/documents/templates/privacy-impact-assessment) ### Privacy impact assessment **Organisation:** Northgate Health Ltd **Project or system:** Patient reminder app **Owner:** Head of Digital **Assessed by:** Priya Nair, Data Protection Officer **Date:** 9 April 2027 ## 1. What the project does Sends appointment reminders by text and lets patients change their booking online. ## 2. Why personal data is needed To remind people of appointments and cut missed visits. ## 3. The data **Personal data used** Name Mobile number Appointment time and clinic No medical notes **Whose data it is** Patients over 16, about 12,000 people **Who else receives it** The text message provider, as our processor, under contract **How long it is kept** Reminders deleted 30 days after the appointment ## 4. Risks to people A wrong number could reveal an appointment to a stranger A breach could expose names and numbers ## 5. Safeguards Confirm the number at booking No clinic details in the text Encrypted storage and staff access limits ## 6. Risk that remains **Level after safeguards:** Risk that remains after the safeguards ## 7. Decision and next steps Go ahead after the number check is built. Review again in 12 months. Signed off by: ______________________ Date: ______________ This assessment is a record of the organisation's own review. It is not legal advice. Templates are a careful starting point, not legal advice. Where the law matters, check what applies where you are. Company and legal ## What this template is for A privacy impact assessment (data protection impact assessment) for a new system or project: data used, why, risks to people, safeguards and sign-off. It is free to fill in online, needs no account, and downloads as a Word document or a PDF. [See all Company and legal templates](https://nerix.ai/templates/company-legal) Company and legal ## What you fill in The form asks for 15 details. The document fills itself in as you type. - ### Organisation For example: Northgate Health Ltd - ### Project or system For example: Patient reminder app - ### Project owner For example: Head of Digital - ### Assessment carried out by For example: Priya Nair, Data Protection Officer - ### Date For example: 9 April 2027 - ### What the project does Two or three sentences, in plain words. For example: Sends appointment reminders by text and lets patients change their booking online. - ### Why personal data is needed For example: To remind people of appointments and cut missed visits. - ### Personal data used One item per line. Mark any sensitive data. For example: Name Mobile number Appointment time and clinic No medical notes - ### Whose data it is For example: Patients over 16, about 12,000 people - ### Who else receives the data (optional) optional For example: The text message provider, as our processor, under contract - ### How long it is kept For example: Reminders deleted 30 days after the appointment - ### Risks to people One risk per line. Think of harm to the person, not to the company. For example: A wrong number could reveal an appointment to a stranger A breach could expose names and numbers - ### Safeguards for each risk For example: Confirm the number at booking No clinic details in the text Encrypted storage and staff access limits - ### Risk that remains after the safeguards - ### Decision and next steps For example: Go ahead after the number check is built. Review again in 12 months. Company and legal ## What is inside The parts of this document, in order. - 1 1. What the project does - 2 2. Why personal data is needed - 3 3. The data - 4 4. Risks to people - 5 5. Safeguards - 6 6. Risk that remains - 7 7. Decision and next steps Templates ## How it works - 01 ### Fill in Type your details in the form. The document fills itself in as you type; click any gap to jump to its field. - 02 ### Check Read it through. Gaps you have not filled stay marked, so nothing goes out half done. - 03 ### Download Save it as a Word document to edit further, or as a PDF to send or print. ### Make it yours with AI Open it in the chat and ask for changes: shorter, firmer, another situation, another language. [Adapt it with nerix](https://nerix.ai/try?template=privacy-impact-assessment) ### Was this template helpful? Company and legal ## Questions people ask ### What details does this template ask for? The form asks for 15 details, starting with Organisation, Project or system, Project owner, Assessment carried out by, Date. 1 more are optional. ### Can I download this template as Word or PDF? Yes. When you have filled in the form, save it as a Word document to keep editing, or as a PDF to send or print. It is free and needs no account. ### Is what I type sent anywhere? No. What you type stays in your browser while you fill in the document. It only goes to nerix if you choose to open the template in the chat. ### What should I check before I use this template? Many data protection laws require an assessment for high-risk uses of personal data, and they differ by country. This template is a working structure, not legal advice. Ask your data protection officer or adviser where one is required. ### Are these company templates free? Most are. Fill in and download them for free as Word or PDF, with no account. A few longer documents are premium: free to fill in, paid once to download, and marked with their price. ### Is a template the same as legal advice? No. A template is a careful starting point. Company, contract and data protection law differ by country, so have a lawyer read anything that carries real risk before you sign. ### Can I change the clauses? Yes. Download the Word version and edit it, or open the template in the nerix chat and ask for a clause that is stricter, shorter or in another language. Templates ## More in Company and legal - [Acceptable use policy Set clear rules for using your systems, accounts, devices and services, and what happens when they are broken. Company and legal](https://nerix.ai/templates/acceptable-use-policy) - [Agency agreement Appoint an agent to find customers and negotiate sales for you in an area, for a commission. Company and legal Premium, €9.99](https://nerix.ai/templates/agency-agreement) - [Anti-bribery policy State that you never give or take bribes, set gift and hospitality limits, and say how to report concerns. Company and legal Premium, €4.99](https://nerix.ai/templates/anti-bribery-policy) - [Board committee terms of reference Define what a board committee is for: members, powers, meetings, reporting and how it is reviewed. Company and legal](https://nerix.ai/templates/board-committee-terms-of-reference) - [Board evaluation form Rate how well the board works as a group, note strengths and gaps, and agree actions for the year ahead. Company and legal](https://nerix.ai/templates/board-evaluation-form) - [Board meeting minutes Record a board meeting: who was there, what was decided and the vote on each resolution. Company and legal](https://nerix.ai/templates/board-minutes) [See all Company and legal templates](https://nerix.ai/templates/company-legal) Templates ## More kinds of documents Every category has its own page, so you can see all of its templates at once. ## Use it in nerix ### Use it in nerix - [Templates](https://nerix.ai/product/templates) - [E-signatures](https://nerix.ai/product/e-signatures) ### Learn more - [How to Make a Document From a Template](https://nerix.ai/help/make-a-document-from-a-template) - [Company and legal](https://nerix.ai/templates/company-legal) ## Keep reading - Quality and audits GDPR [Quality and audits](https://nerix.ai/blog/category/quality-and-audits) November 1, 2026 7 min read ### [GDPR checklist for small businesses](https://nerix.ai/blog/gdpr-checklist-for-small-businesses) A GDPR checklist for small businesses, article by article. Lawful basis, privacy notice, processors, security, 72 hour breach reports and data subject requests. Read the guide