Clinical Rotation Faculty Registration

CONFIDENTIALITY AGREEMENT

I understand that Kindred Healthcare has legal and ethical responsibilities to safeguard the privacy of all patients and to protect the confidentiality of their patients’ health information. I understand I am expected to comply with hospital policies as they relate to maintaining the privacy of our patients’ individually identifiable health information..

I know it is my right and responsibility to seek guidance about privacy issues when I am uncertain about which actions to take.

I will fully cooperate in any investigation of conduct, which may be a violation of hospital policies and standards.

I also agree to the following statements:

1. I will not disclose or discuss any confidential information with others, including friends or family, who do not have a need to know it.
2. I will not in any way divulge, copy, release, sell, loan, alter, or destroy confidential information except as properly authorized.
3. I will not discuss confidential information where others can overhear the conversation. It is not acceptable to discuss confidential information even if the patient’s name is not used.
4. I will not make any unauthorized transmissions, inquiries, modifications, or purging of confidential information.
5. I agree that my obligations under this Agreement will continue after my relationship ceases with the Hospital.
6. Upon termination, I will immediately return any documents or media containing confidential information to the Hospital.
7. I understand that I have no right to any ownership interest in any information accessed or created by me during my relationship with the Hospital.
8. I will act in the best interest of the Hospital and in accordance with its Code of Conduct at all times during my relationship with the Hospital.

Dated this the 6 day of May, 2021.

Checking this box indicates that the information provided is correct and that I agree to the above information.