Confidentiality Agreement

CONFIDENTIALITY VOLUNTEER ACKNOWLEDGEMENT/AGREEMENT

I understand the importance of maintaining the confidentiality of family / patient information including: communications between representatives and family members of the donor, all health care providers, and the public relative to or in connection with any professional services; the name or other information which may identity the potential or actual donors and/or donor families; the name or other information which may identify  transplant recipients; the dates and sites of specific organ recovery referrals or donations; the social history, medical history, physician description, cause of death, and test results specific to a donor, or any other donor specific information.

I agree not to attempt to obtain confidential information outside of the course and scope of my volunteering.  I agree not to divulge any confidential donor or recipient information other than in accordance with the written policies and procedures of MORA.

I understand the importance of the confidentiality acknowledgement agreement and agree to adhere to its policies as stated.

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