Charisma SPD – HIPAA / Confidentiality Training (Required)

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Full Name* This field is required.

First Name

Last Name

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Email Address* This field is required.

example@example.com

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Phone Number* This field is required.

Please enter a valid phone number.

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Role* This field is required.

Employee

Contractor

Intern

Temporary Staff

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Facility / Site

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Supervisor Name

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Date* This field is required.

Date

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This training covers HIPAA basics, PHI in SPD, minimum necessary, verbal/physical/electronic safeguards, incident reporting, and consequences. Do not photograph or share PHI. Report privacy incidents immediately (same shift).

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I understand what PHI is and that I must protect it at all times.* This field is required.

I understand what PHI is and that I must protect it at all times.

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I will follow the Minimum Necessary standard and only access/use PHI needed for my job.* This field is required.

I will follow the Minimum Necessary standard and only access/use PHI needed for my job.

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I will not discuss patient information in public areas or with people who do not have a job-related need to know.* This field is required.

I will not discuss patient information in public areas or with people who do not have a job-related need to know.

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I will not photograph, record, screenshot, or store PHI on personal devices or personal accounts.* This field is required.

I will not photograph, record, screenshot, or store PHI on personal devices or personal accounts.

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I will follow facility and Charisma SPD policies for physical/electronic safeguards and confidential disposal.* This field is required.

I will follow facility and Charisma SPD policies for physical/electronic safeguards and confidential disposal.

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I will immediately report suspected or confirmed privacy/security incidents to my onsite supervisor and Charisma SPD management.* This field is required.

I will immediately report suspected or confirmed privacy/security incidents to my onsite supervisor and Charisma SPD management.

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PHI includes:* This field is required.

Instrument count sheets without identifiers

Patient name + procedure information

Sterilizer cycle printout with no identifiers

Brand names of instruments

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Minimum Necessary means:* This field is required.

Share PHI freely with coworkers

Use only the least PHI needed to do your job

Memorize patient names for accuracy

Take photos to prevent errors

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Taking photos in SPD is:* This field is required.

Always okay if for training

Okay if no patient identifiers and facility allows

Always required

Okay if you delete later

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Discussing patient cases in elevators is:* This field is required.

Acceptable if quiet

Acceptable if no names are used

Not acceptable

Required for teamwork

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You should text PHI:* This field is required.

If it’s urgent

If it’s to your supervisor

Only from your personal phone

Never, unless an approved secure system is used

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PHI paperwork should be disposed of:* This field is required.

Regular trash

Recycling bin

Secure shred/approved confidential bin

Take home and shred

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If you accidentally send info to the wrong person, you should:* This field is required.

Delete it and say nothing

Report immediately

Wait to see if it becomes a problem

Ask the person to ignore it and move on

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Sharing login credentials is:* This field is required.

Allowed if you trust the person

Allowed if you’re busy

Never allowed

Allowed if you change it later

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Which is PHI?* This field is required.

Sterilizer load number only

A tray label with MRN

Instrument brand name

Washer rack number

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Charisma SPD staff must follow:* This field is required.

Only Charisma SPD policies

Only the facility policies

Both facility policies and Charisma SPD confidentiality rules

Whatever is easiest

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Quiz Score

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[Charisma SPD HIPAA/Confidentiality Agreement template text goes here. Please review the full agreement before signing.]

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Signature (E-Sign)* This field is required.

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Typed Full Name* This field is required.

First Name

Last Name

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Date Signed* This field is required.

Date