Electronic records handbook
Table of contents
Appendix D: Confidentiality/Non-disclosure agreement
During my employment with the __________________________, I acknowledge that I will be given access to patient information that is deemed sensitive and/or confidential.
I agree that:
- I shall not share this information, material, or documents (information) with persons within or outside of the ____________________________ who are not authorized to have this information.
- I shall not publish such information.
- I shall not communicate such information without authority.
- I shall not use or disclose any such information for other than authorized official purposes.
- I shall not remove any such information from the premises without permission.
- Should I receive any such information, I will accept full responsibility to ensure the confidentiality and safe-keeping of this information.
- I shall take every reasonable step to prevent unauthorized parties from examining and/or copying and such information.
I understand that these rules apply both during and after my employment with _________________________ and that any infringement by me of these rules may be grounds for the termination of my employment and/or legal action.