Altitude Physical Therapy employees are entrusted with a significant amount of patient and patient-related information including health records, financial records, patient identity and other confidential documents. Patient confidentiality must never be violated. All Altitude employees will ensure the confidential treatment of all health, financial and personnel records. All Altitude employees/volunteers/work study/students/temporary staff are employed with the understanding that they are to diligently support the Altitude Confidentiality Agreement.

Neither patient information for the identity of any patient should ever be discussed in any area, including public areas where a discussion might be overhead by others; nor will health records, financial or personnel documents be taken into common areas like restrooms, employee lounge, waiting areas, mail area etc. Original records may not be taken outside of the Altitude facility, unless in teh custody of an authorized agent of Altitude in response to a valid subpoena.

All patient health records are the property of Altitude. Altitude has the responsibility to maintain these records in order to serve patients and aide the health care providers in accordance with accreditation and regulary agency requirements. Patient care information is confidential and is available only to authorized users on a need-to-know basis in accordance with their predetermined scope of responsibility. Inquiries received by an Altitude employee concerning a patient's condition must be referred to the Release of Information office or Manager of the Health Inforamtion Management Department.

An employee's/volunteer's failure to respect patient confidentiality is a breach of policy and will result in referral to management, which may result in immeidate dismissal from Altitude.

I have read and understand Altitude's policies regarding the privacy of individuals identifiable health information (or protected health information (PHI)) as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPPA) and the State of Colorado. In addition, I acknowledge that I have received training in Altitude's policies concerning PHI use, disclosure, storage and destruction as required by HIPPA.

In consideration of my employment or compensation from Altitude, I hereby agree that I will not at any time - either during my employment or association with Altitude or after my employment or association ends - use, access or disclose PHI to any person or entity, internally or externally, except as is required and permitted in the course of my duties and responsibilities with Altitude as set forth in Altitude's privacy policy and procedures or as permitted under HIPPA. I understand that this obligation extends to any PHI that I may acquire during the course of my employment or association with Altitude, whether in oral, written or electronic form and regardless of the manner in which access was obtained.

I understand and acknowledge my responsibility to apply Altitude's policies and procedures during the course of my employment or association. I aslo understand that unauthorized use or disclosure of PHI will result in disciplinary action, up to and including termination of employments or association with Altitude adn the imposition of civil penalties and criminal penalties under applicable federal and state law, as well as professional disciplinary action as appropriate.

I understand that this obligation will survive the termination of my employment or end of my association with Altitude, regardless of the reason for such termination.