HIPAA Confidentiality Agreement

BridgeCare

HIPAA Confidentiality Agreement

Required

All BridgeCare employees must complete this agreement before beginning work. All fields marked * are required.

1Employee Information

2HIPAA Confidentiality Provisions

As an employee of BridgeCare Home Services LLC, I agree to the following:

  • I will access only the minimum necessary client health information required to perform my job duties.
  • I will not disclose client health information to unauthorized individuals, including family members, friends, or other employees not involved in the client's care.
  • I will not discuss client health information in public areas or where unauthorized persons may overhear.
  • I will not access, use, or disclose client health information for personal gain or curiosity.
  • I will report any suspected or known violations of HIPAA to my supervisor or the Privacy Officer immediately.
  • I understand that violations of this agreement may result in disciplinary action, up to and including termination and civil or criminal penalties.
  • I will complete all required HIPAA training as directed by BridgeCare.
  • I will safeguard all physical and electronic records containing protected health information.
  • This agreement remains in effect after my employment with BridgeCare ends.

3Electronic Signature

By typing your full name below, you agree to the HIPAA Confidentiality Agreement as stated above.

BridgeCare

Your submission will be sent securely to our team at referrals@bridgecareohio.com. A completed PDF copy will be available for download after submission.