Statement of Confidentiality - volunteer annual ed

An integral part of the quality of service that Hospicare offers its patients and families is absolute confidentiality.

Revealing any information of a personal nature, which you may learn while working/visiting as a hospice staff member/volunteer/visitor/independent contractor is prohibited, even in the strictest of confidence, to a close friend, family member or others.

In addition, Hospicare staff member/volunteers/visitor/independent contractor are not authorized to reveal or discuss patient information with family or friends of the client, unauthorized persons in the agency, the news media, or the public.

At no time is the name of the patient or their family used unless it is necessary in the delivery of service for that person. You are asked not to identify clients by name with anyone other than members of the Hospicare staff.

I have read and understand the above statement of confidentiality and I agree to abide by the guidelines set forth.

By checking this box and signing my name below I am electronically signing this form.

Employee's Signature*

Employee's printed name*

Date*

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