New Mexico Statewide Immunization Information System (NMSIIS) User Security and Confidentiality AgreementUser Security and Confidentiality Agreement • December 19th, 2019
Pursuant to its public health authority under the Public Health Act, section 24-1-3, NMSA 1978 to prevent, suppress, and conduct surveillance of disease and under the Immunization Act, sections 24-5-7 to 15, NMSA 1978 to establish and maintain a statewide immunization registry the New Mexico Department of Health (NMDOH) operates and maintains the New Mexico Statewide Immunization Information System (NMSIIS).
New Mexico Statewide Immunization Information System (NMSIIS) User Security and Confidentiality AgreementUser Security and Confidentiality Agreement • December 28th, 2023
ContractUser Security and Confidentiality Agreement • February 2nd, 2021
User Security and Confidentiality Agreement I have been authorized by “Name of Practice” to access health information of current patients of the Practice, through the EpicCare Link software, a secure electronic database of protected health information (PHI) owned by UF Health.* Practice has entered into a separate “UF Health EpicCare Link User Agreement” with UF Health establishing the terms and conditions by which Practice and its employees and agents shall be permitted to access the aforementioned secure electronic database for the limited purpose as herein stated and Practice has authorized me, as its agent and/or employee, to receive individual access credentials to this database pursuant to the terms of that agreement. In consideration for receiving individual access credentials (User ID and password) and access to the UF Health database, I hereby agree as follows: 1. Limited Purpose: I will only access PHI for the sole purpose of obtaining health information about the treatment
User Security and Confidentiality AgreementUser Security and Confidentiality Agreement • December 2nd, 2020
Comply with the Department of Public Health and Social Services’ (DPHSS) Guam Immunization Registry (GuWebIZ) Security and Confidentiality Policy and my organization’s normal protocol for releasing identifiable immunization information for clients.
ContractUser Security and Confidentiality Agreement • April 23rd, 2019
STATEWIDE INCIDENT MANAGEMENT SYSTEM (SIMS) USER SECURITY AND CONFIDENTIALITY AGREEMENT Individually identifiable information relating to applicants/clients/recipients of the Louisiana Department of Health (LDH) is confidential and must be safeguarded in accordance with applicable legal requirements, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its regulations governing the privacy and security of individually identifiable health information, federal Medicaid law and regulations, Louisiana law, and the rules, policies, and procedures of LDH, as applicable. Such information shall not be shared with anyone outside LDH except in compliance with those legal requirements.Falsification of any document or information is strictly prohibited.Federal penalties may be imposed in addition to state penalties. Any person who knowingly discloses individually identifiable health information in violation of the HIPAA Privacy Rule shall be sub
ContractUser Security and Confidentiality Agreement • September 26th, 2022
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
USER SECURITY AND CONFIDENTIALITY AGREEMENTUser Security and Confidentiality Agreement • April 22nd, 2010
• Comply with the Wisconsin Blood Lead Registry (WBLR) Organization Security and Confidentiality Agreement (DPH F-00116) and my organization's normal protocol for releasing identifying information for clients.
SAIRS User Security and Confidentiality AgreementUser Security and Confidentiality Agreement • December 18th, 2012
The San Antonio Immunization Registry System (SAIRS) is a confidential, Web based immunization information system administered by the San Antonio Metropolitan Health District's Immunization Division. SAIRS contains Protected Health Information (PHI) of individuals, which is to be treated in a manner that preserves the confidentiality
DEPARTMENT OF PUBLIC SOCIAL SERVICESUser Security and Confidentiality Agreement • October 2nd, 2012
This Agreement applies to all employees, contractors, subcontractors, vendors, volunteers and any other users of the County of Los Angeles (County) Department of Public Social Services (DPSS) YBN System, whether permanent, temporary, part-time, or in any other status. Only DPSS-authorized users are permitted to use the YBN System. It comprises the entire Agreement between the user and DPSS and supersedes any prior agreements pertaining to the subject matter herein.
SAIRS User Security and Confidentiality AgreementUser Security and Confidentiality Agreement • December 13th, 2012
USER SECURITY AND CONFIDENTIALITY AGREEMENTUser Security and Confidentiality Agreement • October 27th, 2011
The KSWebIZ contains confidential identifying data and information of individuals, which is to be treated in a manner that preserves the confidentiality and privacy of those individuals. By signing this agreement, the user named below affirms he/she and/or his/her organization is accessing this data in compliance with state and federal law and for the purpose of achieving age- appropriate immunization status for individuals whose information is accessed.
MI-WIC POLICY Equipment MaintenanceUser Security and Confidentiality Agreement • July 31st, 2009
