HIPPA Privacy & Security – Public Health Institute of Oklahoma

Role (Choose all that apply): *

CATCH-UP Volunteer
Coalition Member
Partner Organization Member
PHIO Contract

I understand and agree to the following: *

I am responsible for reviewing, understanding, and complying with HIPAA Privacy & Security policies and procedures and state and federal laws protecting the privacy of health information;
I will perform my duties in good faith and in a manner that is in the best interests of the Public Health Institute of Oklahoma and the communities I serve;
I will preserve client confidentiality, except as otherwise permitted or required by law, unless there is written permission to disclose information;
I will promptly report any activity that I believe in good faith may violate state HIPAA Privacy or Security policies and procedures, or any other applicable law, regulation, rule, or guideline, in accordance with the reporting procedures set forth in the state and federal laws protecting the privacy of health information;
I will comply with Oklahoma HIPAA Privacy & Security Rule policies and procedures. When in doubt about what constitutes compliance performance, I will consult with the Public Health Institute of Oklahoma.

Affirmation *

First

Last

I certify that I have received training in HIPAA Privacy and Security Policies and Procedures, and will comply with state and federal privacy laws. I understand that willful or malicious release of any information associated with Protected Health Information may result in personal civil or criminal liability. I understand that when necessary, I should seek advice from the appropriate sources concerning appropriate actions that I may need to take in order to comply with the HIPAA Privacy & Security Policies and Procedures.

Date *

RESOURCES

https://www.healthit.gov/providers-professionals/guide-privacy-and-security-electronic-health-information

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf

https://apps.ouhsc.edu/hipaa/