Geriatric Patient Confidentiality Agreement

Agreement

This agreement is made between

(referred to as the "Recipient") and the healthcare organization/facility.

Purpose

The purpose of this agreement is to ensure that all information relating to geriatric patients is kept confidential and handled in accordance with applicable laws and ethical standards.

Confidential Information

Confidential information includes, but is not limited to, patient names, contact details, medical records, diagnoses, treatment information, and any other personal or health-related information.

Obligations

Term

This agreement remains in effect for the duration of the Recipient's association with the organization and thereafter, as required by law.

Breach of Agreement

Unauthorized disclosure or misuse of confidential information may result in disciplinary action, termination, and/or legal consequences.

Recipient Signature
Date
Printed Name
Organization Representative