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6.1.E. - Page 18 <br /> SAN MATEO COUNTY <br /> HEALTHSYSTEM <br /> DECLARATION OF NOTICE OF CONFIDENTIALITY <br /> As an employee, contractor, or associate of San Mateo County Health System, I agree to the <br /> following as evidenced by my signature affixed below: <br /> I will not disclose or otherwise discuss Health System patients or clients, their conditions, <br /> treatments or status, even if they are known to me personally,with anyone, except to carry out my <br /> assigned duties associated with their proper care or treatment. <br /> I will not release information to anyone concerning the financial,medical, or social status of <br /> Health System patients or clients which has not first been authorized according to written Health <br /> System policies, federal or state regulation, or otherwise properly ordered by legal authorities. <br /> I will not, at any time or under any circumstances, disclose or share any Health System assigned <br /> computer system User ldentification or password to anyone. <br /> I will not tamper with any Health System computer system to gain unauthorized access to the <br /> network or information contained there. <br /> I will take all reasonable care to prevent the unauthorized use, disclosure or availability of <br /> confidential and/or proprietary information through unattended screen displays or by mishandling <br /> of system generated output,regardless of its form. <br /> I acknowledge that the Health System retains the right to monitor and/or review, at any time and <br /> without cause, any access to the Health System computer services for evidence of tampering or <br /> misuse, and may, at its sole discretion, suspend or terminate the Health System computer <br /> privileges pending administrative review. <br /> I agree to adhere to policies concerning the Health System`s computer services and understand <br /> that any misconduct and/or breaches of confidentiality expressly described herein may be grounds <br /> for immediate suspension of computer privileges. In addition, Health System`s administrative <br /> actions,up to and including termination of employment or contract may result. Additionally, <br /> violation of any applicable civil or criminal statutes by the disclosure of confidential material or <br /> information or other misuse of the computer system will be prosecuted to the fullest extent of the <br /> law. <br /> Employee or Contractor Signature Date Signed <br /> Print Employee or Contractor Supervisor Signature <br /> First Name, Middle Name, and Last Name <br /> Employee or Contractor Title Location/Contract Agency <br />