Confidentiality Policy Agreement
As a student or intern with Scotland County Health Department (SCHD), I agree to comply with all confidentiality policies and procedures set in place. I realize that it is privileged information and is not to be shared with anyone other than a current employee of Scotland County Health Department and ONLY in an official capacity. If I, at any time, knowingly or inadvertently breach the patient confidentiality policies and procedures, I must notify the Health Director or the agency’s HIPAA Officer immediately. Also, per General Statue 130A-143, I agree that all information and records, whether publicly or privately maintained, that identify a person who has the AIDS virus infection or who has or may have a disease or condition required to be reported pursuant to the provisions of this Article shall be strictly confidential. I understand that any violation of this agreement or Scotland County Health Department’s policies related to access, use or disclosure of confidential information may result in significant legal ramifications for which I will be held solely responsible with respect to this Agreement.
Furthermore, I also give Scotland County Health Department permission to reproduce pictures or news articles pertaining to my service in the agency, as long as it is not a confidential matter. I understand that I am obligated to report any solicitation for confidential information to my supervisor. By my initials and signature below, I have read and understand, and have been given the opportunity to ask questions regarding the Scotland County Health Department Confidentiality Policy.