Confidentiality Agreement

Agreement for Students, Temporary Employees, Career Job Shadowing and Clinical Rotations

St. Mary’s Medical Center has a legal and ethical responsibility to protect the privacy of all patients and to take appropriate safeguards to protect their health information.  I understand that in the course of my Career Shadowing experience  I may  come  into  contact with  confidential  patient  information.  This information includes verbal communication, documented material such as  that found in medical records  as well  as  computerized  information  available  in  healthcare  computer  systems.  I understand that such information must be maintained in the strictest confidence.  

I hereby agree that I will not at any time during or after my experience at St. Mary’s Medical Center disclose any patient information to any person or use patient information, other than as necessary in the course of  my  Career  Shadowing  experience.    I also agree to protect this information by using appropriate safeguards  including  but  not  limited  to,  speaking  in  a  lowered  voice,  avoiding conversations  in  public  areas,  and  disposing  of  material  containing  confidential  information  in appropriate receptacles.  

I agree to adhere to St. Mary’s Medical Center’s HIPAA policies 100.418 Protected Health Information and 100.419 HIPAA Administrative Policy (will be provided upon request).

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