I will hold harmless the Rainbow Community Center should I incur any injury while working as a volunteer. I will follow the policies of the Rainbow Community Center and agree to maintain confidentiality even if I am no longer a volunteer.
Laws controlling the privacy of, access to, and maintenance of confidential information include, but are not limited to, the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the legal and ethical standards of the California Board of Behavioral Sciences. There and other laws apply whether the information is held in electronic or any other format, and whether the information is used or disclosed orally, in writing or electronically.
Confidential information includes information that identifies or describes an individual, the disclosure of which would constitute and unwarranted invasion of personal privacy. Examples of this include home address and telephone number; medical information; birth date; citizenship; social security number; spouse/partner/relative’s names; income tax withholding data; and performance evaluations.
Medical information includes the following no matter where it is stored or in what format: psychotherapy records, photos, videotapes, diagnostic and therapeutic reports, bills for service or insurance information, visual observation of clients receiving or accessing services, and verbal information provided by or about a patient. Medical information, including Protected Health Information (PHI), is maintained to serve the client, health providers, health care research and to confirm to regulatory requirements.
Unauthorized use, disclosure, or viewing of, or access to, confidential information in violation of state and/or federal laws may result in personal fines, civil liability, licensure sanctions and/or criminal sanctions, in addition to Agency disciplinary actions.
Acknowledgement of ResponsibilityI understand and acknowledge that:
I have read, understand and acknowledge all of the above STATEMENT OF PRIVACY LAWS AND AGENCY POLICY and the ACKNOWLEDGEMENT OF RESPONSIBILITY
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