Northwest Florida Community Hospital 1360 Brickyard Road Chipley, Florida 32428 WARNING! Please Read Both Forms Below Compliance Agreement This electronic patient record originates from Northwest Florida Community Hospital. These patient records are only for the use of authorized physicians, nurses, employees, students, or staff who have signed confidentiality agreements on file with the entity from which these records are obtained. These records contain information which is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. Browsing for information regarding patients that are not under your immediate care is strictly prohibited, as is tampering or otherwise interfering with the electronic information delivery system. Patient care decisions should not be based solely on the medical images or audio report summaries that can be accessed here. Integration of clinical and laboratory information, review of the final radiology report, and, when appropriate, consultation with the radiologist(s) are recommended.


Web Page Access and Confidentiality Agreement for NORTHWEST FLORIDA COMMUNITY HOSPITAL Access and Confidentiality Agreement (Physician/Employee/Volunteer/Student) As a physician/nurse/employee/volunteer/student with access to medical images and reports from NORTHWEST FLORIDA COMMUNITY HOSPITAL, you will have access to what this agreement refers to as "confidential information." The purpose of this agreement is to help you understand your duty regarding confidential information. Confidential information includes patient information, medical images, and reports. You may learn of or have access to some or all of this confidential information through a computer system or through your employment activities. Confidential information is valuable and sensitive and is protected by law and by strict NORTHWEST FLORIDA COMMUNITY HOSPITAL policies. The intent of these laws and policies is to assure that confidential information will remain confidential - that is, that it will be used only as necessary to provide authorized patient care. As a physician/employee/volunteer/student, you are required to conduct yourself in strict conformance to applicable laws and NORTHWEST FLORIDA COMMUNITY HOSPITAL policies governing confidential information. Your principal obligations in this area are explained below. You are required to read and to abide by these duties. The violation of any of these duties will subject you to discipline, which might include, but is not limited to, termination of employment and to legal liability. Accordingly, as a condition of and in consideration of your access to confidential information, you promise that: 1. You will use confidential information only as needed to perform your legitimate duties as a physician/employee/volunteer/student receiving information from NORTHWEST FLORIDA COMMUNITY HOSPITAL. This means, among other things, that: A. You will only access confidential information for which you have a need to know; and B. You will not in any way divulge, copy, release, sell, loan, review, alter or destroy any confidential information except as properly authorized by NORTHWEST FLORIDA COMMUNITYHOSPITAL. C. You will not misuse confidential information or carelessly care for confidential information. 2. You will safeguard and will not disclose your access code or any other authorization you have that allows you to access confidential information. 3. You accept responsibility for all activities undertaken using your access code and other authorization. 4. You will report activities by any individual or entity that you suspect may compromise the confidentiality of confidential information. Reports made in good faith about suspect activities will be held in confidence to the extent permitted by law, including the name of the individual reporting the activities. 5. You understand that your obligations under this Agreement will continue after termination of your employment. You understand that your privileges hereunder are subject to periodic review, revision and if appropriate, renewal. 6. You understand that you have no right or ownership interest in any confidential information referred to in this Agreement. NORTHWEST FLORIDA COMMUNITY HOSPITAL may at any time revoke your access code, other authorization, or access to confidential information. At all times during your employment, you will safeguard and retain the confidentiality of all confidential information. 7. You will be responsible for your misuse or wrongful disclosure of confidential information and for your failure to safeguard your access code or other authorization access to confidential information. You understand that your failure to comply with this Agreement may also result in your loss of employment and other legal liability. 8. By entering the site below you agree to all the previous terms and conditions.

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