Medical Association of Georgia Medical Reserve Corps Confidentiality Agreement
I realize that as a member of the MAG Medical Reserve Corps, in association with the institutions and agencies supported, I may acquire knowledge of confidential information from files, case records, missions, conversations, etc. I agree that such information is not to be discussed or revealed to anyone not authorized to have the information.
By my signature below, I hereby affirm that I understand the rules of patient confidentiality as governed by the Health Insurance Portability and Accountability Act (HIPPA) and by accepted standards in healthcare.
I understand that a patient's privacy is to be protected at all times, and that a patient's private personal and health information is to be shared only with other health care and public safety providers who have a need to know such information in order to appropriately assist in or take over the care of said patient.
I hereby accept my ethical and legal responsibility to protect the privacy rights of patients for whom I provide or assist in medical or personal care. I will share a patient's medical and personal information only with those who must have that information to assist in or take over that patient's care.