SERVICES CONFIDENTIALITY AGREEMENTServices Confidentiality Agreement • October 26th, 2015 • Ohio
This agreement (“Agreement”) is made as of , 20 (“Effective Date”) by and between (“Provider”) a corporation with its principal place of business at and Miami University (the “University”), a state assisted institution of higher education located at 501 E. High Street, Oxford, OH 45056.
Supervised Visitation Services CONFIDENTIALITY AGREEMENTServices Confidentiality Agreement • July 7th, 2022
All interactions which take place in the setting of supervised or therapeutic visitations are considered confidential. This includes requests by telephone, all interactions with this counselor, any scheduling or appointment notes, all session content records and any progress notes that I take during your sessions. I will not even verify that you are a client. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate.
MISSOURI DEPARTMENT OF SOCIAL SERVICES DIVISION OF FAMILY SERVICES CONFIDENTIALITY AGREEMENTServices Confidentiality Agreement • September 17th, 2020
All persons using or inquiring the Division of Family Services FAMIS must read and sign this confidentiality agreement that describes the many state and federal laws and regulations that safeguard our client information. The specific laws governing the use of the information received are below. Laws apply regardless of how we receive the information, i.e. from the client themselves, from a collateral, a document or a computer match, etc. Responsible handling of information dictates not only “what” is shared and “to whom” but also “where”. Do not share information about clients over lunch, coffee breaks, in halls or elevators where others may overhear names or identifying information. Remember each individual contributes to the collective professional reputation of an agency. You may be reprimanded, with a copy in your permanent file, suspended without pay or fired for violating these confidentiality laws and regulations. Violation of some of the laws may result in misdemeanor or felo
Aging & Independence Services Confidentiality AgreementServices Confidentiality Agreement • September 10th, 2012
The purpose of this agreement is to protect the confidential information and the privacy of individuals who receive services or assistance through the programs administered by Aging & Independence Services (AIS).
