I understand that Journey Pediatric Therapy (JPT) is committed to protecting patient confidentiality and privacy, as well as maintaining compliance with all relevant HIPAA regulations. Iwill not use, disclose or in any way reveal or disseminate to unauthorized parties any information I gain through contact with materials, medical records, claims, computer systems, logs, or conversations that are made available to me during my time at JPT. I also understand I may not take pictures, audio recordings or video recordings of any patients, therapists, or any documents.
I share the commitment of JPT to protect patient confidentiality and by my signature on this document, pledge compliance with the terms of the Confidentiality Policy and Privacy Agreement. I understand that I shall be responsible for any direct or consequential damages resulting from any violation of this Agreement. The obligation of this Agreement shall remain in effect even after my time at JPT has ended.
I have read and have been given an opportunity to voice any questions or concerns regarding this Agreement. I understand the terms of this Agreement and agree to adhere to them.