I understand that a medical record or any information taken from a medical record is privileged and confidential. 8. Create and download agreements for.A confidentiality statement is a document that states that the information disclosed to the recipient can't be disclosed to anyone outside the agreement. Learn about the scope, nuances, and limitations of confidentiality and nondisclosure agreements, and download a confidentiality agreement template. Describe and mention all the terms that both parties are agreeing to. This is crucial to the agreement and requires confidentiality. Public Information Act.