Sample Generic Medical Confidentiality Agreement - Free Download
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Sample Generic Medical Confidentiality Agreement
Sample Generic Medical Confidentiality Agreement
Confidentiality Agreement
For Interns
Due to your access to confidential information, all students enrolled in CTVA internships must
sign this agreement. “Confidential information” means any information of a secret or confidential
nature relating to the internship workplace.
Confidential information may include, but is not limited to, the following: trade secrets,
proprietary information, customer information, customer lists, methods, plans, documents, data,
drawings, manuals, notebooks, reports, models, inventions, formulas, processes, software,
information systems, contracts, negotiations, strategic planning, proposals, business alliances, and
training materials.
In connection with being enrolled in a CTVA internship, I agree to the following:
I have read and understand the above definition of “confidential information.” I agree that I will
not at any time, both during and after my enrollment in a CTVA internship, communicate or disclose
confidential information to any person, corporation, or entity.
I further recognize and agree that while in a CTVA internship, I may become aware of
nonpublic information of a personal nature about employees or associates, including, without
limitation, actions, omissions, statements, or personally identifiable medical, family, financial, social,
behavioral, or other personal or private information. I will not disclose any such information that I
learn in a CTVA internship to any other person or entity, unless required by applicable law or legal
process.
______________________________ ______________________________
(Signature) (Date)
______________________________
(Print name)
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