Confidentiality of Information Statement

Please read the following and submit your agreement at the end. Thank you!

• All information pertaining to patients, medical records and reports or personnel is strictly confidential.
• Anyone found reading records, discussing patient information or imparting confidential information, except when authorized to do so, is subject to dismissal.
• Having received this statement, the volunteer named below is required to respect and keep absolutely confidential all information pertaining to patients, medical records or staff personnel matters. Failure to maintain the confidentiality of hospital information will subject the volunteer to disciplinary action in accordance with the Administrative section of the Associate Guideline (R-G.1.0).

By my electronic signature below (Initials), I am indicating that I have read, understand and agree to adhere to the conditions of this Confidentiality Agreement for continued affiliation with Ephraim McDowell Regional Medical Center.