If you have nursing, therapy and administrative staff accessing an electronic EMR system you need have to make sure each employee signs an EMR Confidentiality Form - also known as a Non-Disclosure Form. A confidentiality or non-disclosure agreement is absolutely necessary for an Agency or any other party who needs to protect confidential and sensitive data - such as patient information. As the importance of the confidential information increases, so does the relative complexity of the Agreement. This page presents only the basic elements of a non-disclosure agreement. This sample contract does not contain the more complex elements that would be required in a larger agreement.
AS WITNESSED BY BOTH PARTIES:
The employee has been issued a computer password or “key” that enables her/him to access the Agency’s information system. In consideration of mutual promises and agreements set forth, both employee and Agency agree to the following:
1. Security and confidentiality.
This agreement shall be in effect for _______________ (months) from the date first written above. This agreement is automatically terminated in the event of the suspension or termination of employment, or the occurrence of any condition or circumstance that would legally, physically, or mentally prevent the employee from performing her/his job duties under this agreement.