Confidentiality and Non-Disclosure Agreement.
As an employee / contracted employee affiliated with the (name of organization), I understand that I must maintain the confidentiality of any and all data and information to which I have access. Organizational information that may include, but is not limited to, financial, patient identifiable, employee identifiable, intellectual property, financially nonpublic, contractual of a competitive advantage nature and is from any source or in any form(i.e. paper, magnetic or optical media, conversations, film etc.), may be considered confidential. The value and sensitivity of information is protected by law and by the strict policies of (name of organization). The intent of these laws and policies is to assure that confidential information will remain confidential through its use, only as a necessity to accomplish the organizations mission.
As a condition to receiving a computer sign-on code and allowed access to a system and/or being granted authorization to access any form or confidential information identified above, I agree to comply with the following terms and conditions:
1. My sign-on code is equivalent to my Legal Signature and I will not disclose this code to anyone or allow anyone to access the system using my Sign-On Code.
2. I am responsible and accountable for all entries made and all retrievals accessed under my Sign-On Code, even if such action was made by me or by another due to my intentional or negligent act or omission. Any data available to me will be treated as confidential information.
3. I will not attempt to learn or use another’s Sign-On code.
4. I will not access any on-line computer system using a Sign-On Code other than my own.
5. I will not access or request any information for which I have no responsibility.
6. If I have a reason to believe that the confidentiality of my User Sign-On Code/password has been compromised, I will immediately notify (responsible party) by calling the helpdesk at (helpdesk phone number).
7. I will not disclose any confidential information unless required to do so in the official capacity of my employment or contract. I also understand that I have no right or ownership interest in any confidential information.
8. While signed on, I will not leave a secured computer application unattended.
9. I will comply with all policies and procedures and other rules of (name of organization) relating to confidentiality of information and sign-on codes.
10. I understand that my use of the system may be periodically monitored to ensure compliance with this agreement.
11. I agree not to use the information in any way detrimental to the organization and will keep all such information confidential.
12. I will not disclose protected health information or other information that is considered proprietary, sensitive, or confidential unless there is a need to know basis.
13. I will limit distribution of confidential information to only parties with a legitimate need in performance of the organizations mission.
14. I agree that disclosure of confidential information is prohibited indefinitely, even after termination of employment or business relationship, unless specifically waived in writing by an authorized party.
15. This agreement cannot be terminated or canceled nor will it expire.
16. I will report to the Corporate Compliance Hotline any unauthorized access or use of confidential information. I understand that my reporting is confidential and that I will remain anonymous.
I further understand that if I violate any of the above terms, I may be subject to disciplinary action, including discharge, loss of privileges, termination of contract, legal action, and any other remedy available to (name of organization).
User’s Name:___________________________ Date_________________________
User’s Signature: ________________________ Department: ___________________
