Common Contracts

Contract

Security and Confidentiality Agreement • August 13th, 2020

• Contract Type
  Security and Confidentiality Agreement
• Filed
  August 13th, 2020

DEPARTMENT OF HEALTH SERVICESDivision of Public Health F-02163 (06/2019) STATE OF WISCONSINWEDSSPage 1 of 2 TUBERCULOSIS ORDERING AND BILLING INTERFACE (TOBI) USER SECURITY AND CONFIDENTIALITY AGREEMENT Login Name/ID User Role (check all that apply) WI Division of Public Health Staff Local Public Health Staff Pharmacy Staff Clinical Staff Organization Name Organization Address City State Zip I understand that the information in this application is protected by federal and state laws. I agree to be legally and ethically responsible for protecting the confidentiality, integrity, and security of all protected data and information to which I have access. By signing this agreement, I agree to:  Comply with the Wisconsin Division of Public Health (DPH) Wisconsin Electronic Disease Surveillance System (WEDSS) Security and Confidentiality Policy, and my organization’s standard policies and procedures related to confidentiality and release of personally identifying healt