HIPAA (Employee) Non-Disclosure Agreement (NDA) Template

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Formats: Adobe PDF & MS Word
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The HIPAA Confidentiality And Non-Disclosure Agreement Template is useable by Healthcare Facilities wishing to obtain a binding signature from a new hire. This paperwork will focus upon the call for confidentiality as defined in the Health Insurance Portability Act of 1996 and HIPAA Omnibus Rule of 2013. When a Healthcare Facility hires a new employee it must face the fact this new hire will be exposed to a substantial amount of confidential information about the facility, the employees, and even the patients. Some level of assurance this information remains confidential and is not irresponsibly dispensed will need to be obtained from the new employee. This template will structure the language required to set definitions and responsibilities the new employee will need to be made aware of and agree with.

As a result, this document will go through some effort to cover the concept of confidential information as well as what the Employee’s attitude and behavior should be regarding his or her Employer’s information. Naturally, the Employee should be given enough time to review all these terms thoroughly so that an informed signature may be supplied at the end of this document. Once this agreement is signed it will possess the same binding power as a contract thus, making it enforceable in a court of law.

How To Write

1 – This Agreement Should Be Downloaded From This Page

You may obtain this agreement as either and Adobe PDF  file or an MS Word (.docx) document by simply selecting the appropriate link below. If you lack the compatible software to edit this onscreen, you may open it as an Adobe File with an updated browser then print it. When filling it out manually, make sure all the information presented is perfectly legible.

2 – Date This Paperwork

The Date when this paperwork is being agreed to and entered into by the New Employee should be presented in the first statement. Locate the phrase “…Entered Into This” then, enter Two-Digit Calendar Date on the first blank line, the Month on the second blank line, and the Two-Digit Year when this document is being executed on the third blank line.

2 – The Name Of Each Concerned Participant Must Be Documented

The next task to perform will be to present the Legal Name of the Health Care Facility in the empty space between the words “…By And Between” and “Hereinafter Referred To As…”

The last blank space in this paragraph calls for the Name of the Employee agreeing to the terms placed in this agreement.

3 – The Employee Can Only Enter This Agreement With A Signature

After reading through this document to his or her satisfaction, the Employee must sign his or her Name on the blank line labeled “Employee’s Signature.”

On the blank space below his or her Signature (labeled “Printed Name”), the Employee must present his or her Name in print.

The Employee must enter the Date he or she signs this paperwork on the last blank space. Note: This date should be the same as that reported in the first paragraph.