Get Integrity In Action, Hipaa And Compliance Acknowledgment Form

Filling out the Integrity In Action, HIPAA And Compliance Acknowledgment Form is an essential step for individuals involved in clinical experiences at Duke University Health System. This guide will provide you with clear and supportive instructions to effectively complete the form online.

Follow the steps to fill out your acknowledgment form correctly.

1. Click the ‘Get Form’ button to obtain the acknowledgment form and open it in your online editor.
2. Read the content statement carefully. It outlines your responsibilities regarding the Duke Medicine Code of Conduct and HIPAA Privacy & Security. Ensure you fully understand these terms before proceeding.
3. In the 'I Agree' section, indicate your agreement by selecting the checkbox or marking your consent to abide by the terms outlined in the document.
4. Sign your name in the designated 'Sign Name' field, confirming your acknowledgment. Use your legal name as you would sign it on official documents.
5. Print your name in the 'Print Name' field, providing clarity on who has signed the document.
6. Enter the date of completion in the 'Date' field. Make sure to use the current date to reflect when you filled out the form.
7. After completing all fields, review the form for accuracy. Ensure all information is correct before finalizing.
8. Once you have verified the form, save any changes made. You can also download, print, or share the form as needed for your records.

Complete the acknowledgment form online today to ensure your participation in clinical experiences.