California Confidentiality Agreement Addressed to Party Presenting Data and / or Information

State:
Multi-State
Control #:
US-OG-193
Format:
Word; 
Rich Text
Instant download

Description

This form is a confidentiality and non-disclosure agreement used to impose confidentiality obligations on parties receiving information on materials, preventing the disclosure of information or material.
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FAQ

Hear this out loud Pause?Disclosing Party? means the party disclosing Confidential Information to the other party, including any Affiliate of such other party. ?Receiving Party? means the party receiving Confidential Information from the other party, including any Affiliate of such other party.

I will not access any medical record I am not legally authorized to, including but not limited to the medical record of any family member or co-worker. 4. I will utilize and access only the minimum amount of information necessary for performance of my job.

I agree to treat the identity of all identifying information about clients and other members of the AGENCY NAME as well as the location and other identifying information about the shelter, and transitional houses as confidential. Clients' names will not be mentioned outside the structure of the program.

Here are some examples of confidential information: Name, date of birth, age, sex, and address. Current contact details of family. Bank information. Medical history or records. Personal care issues. Service records and file progress notes. Personal goals. Assessments or reports.

I am not permitted to access, view, and alter (change) confidential information unless I have received authorization as required to complete my job responsibilities, and that I will access, view, and alter (change) only the confidential information records needed to perform those job duties.

Hear this out loud PauseThe agreement should identify the purpose to which the recipient can put the confidential information. All other uses of the confidential information should be prohibited. Sometimes a confidentiality agreement states that no rights are licensed by the confidentiality agreement. This is stating the obvious.

Hear this out loud PauseA confidentiality agreement should include a clear definition of the confidential information, scope of the agreement, obligations of the receiving party, the duration of the contract, any exceptions to confidentiality, and the consequences of a breach of the contract.

Hear this out loud PauseI agree that: a) I shall not share this information, material or documents (information) with persons within or outside of the ________ who are not authorized to have this information. b) I shall not publish such information. c) I shall not communicate such information without authority.

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California Confidentiality Agreement Addressed to Party Presenting Data and / or Information