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Medical Center Confidentiality Agreement Mobile App

A Medical Center has a legal and ethical responsibility to safeguard the privacy of all patients and to protect the confidentiality of their health information. Additionally, the organization must assure the confidentiality of its human resources, payroll, financial, research, computer systems, and management information. Such information may be in any form, including paper records, oral communications, audio recordings, and electronic displays. In addition, personal access code(s), user ID(s) and passwords used to access computer systems are also an integral part of this confidential information. The Medical Center Confidentiality Agreement mobile app covers all of these aspects of confidentiality. This app can be modified to your Medical Centers Policies.

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

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Take a peek inside the Medical Center Confidentiality Agreement Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    (Medical Center) has a legal and ethical responsibility to safeguard the privacy of all patients ...

  • Ico statictext

    By signing this document I understand the following:

  • Ico statictext

    I agree not to disclose or discuss any patient, human resources, payroll, financial, research and...

  • Ico statictext

    I agree not to access any information, or utilize equipment, other than what is required to do my...

  • Ico statictext

    I agree not to discuss patient, human resources, payroll, financial, research or management infor...

  • Ico statictext

    I agree not to make inquiries for other persons who do not have proper authority.

  • Ico statictext

    I agree not to willingly inform another person of my computer password or knowingly use another p...

  • Ico statictext

    I agree not to make any unauthorized transmissions, inquiries, modifications, or purging of data ...

  • Ico statictext

    I agree to log off prior to leaving any computer or terminal unattended.

  • Ico statictext

    I agree that I have a duty to report any breach of confidentiality that I may observe or become a...

  • Ico statictext

    I understand that violation of this agreement may result in corrective action, up to and includin...

  • Ico statictext

    I have read and agree to comply with the terms of the above statement, and will read and comply w...

  • Ico textbox

    Name

  • Ico textbox

    Employee #

  • Ico checkbox

    Department

  • Ico checkbox

    Resident

  • Ico checkbox

    Employee

  • Ico checkbox

    Medical Staff Physician

  • Ico checkbox

    Referring Physician

  • Ico checkbox

    Volunteer

  • Ico checkbox

    Student

  • Ico textbox

    School

  • Ico checkbox

    Other

  • Ico textbox

    Other

  • Ico signature

    Signature

  • Ico date

    Date

  • ...and More!

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