Download Personal Confidentiality Agreement Template for Free

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THIS CONFIDENTIALITY AGREEMENT is made this day of

20 .

B E T W E E N:

(Hereinafter Referred to as the “Researcher”)

- and -

ROYAL VICTORIA REGIONAL HEALTH CENTRE

(Hereinafter referred to as RVH)

WHEREAS (name of researcher) is a

clinical researcher wishing to access confidential data contained in the medical records

and/or patient charts of the RVH..

AND WHEREAS the RVH considers itself ethically and legally bound to protect the

confidentiality of such information within the limits prescribed by Good Clinical Practice,

TCP Ethical Guidelines and all applicable legislation including, without limitation, the

Personal Information and Protection of Electronic Documents Act 2003 and the Personal

Health Information Protection Act, 2004;

NOW THEREFORE, for valuable consideration, the receipt and sufficiency of which is

hereby acknowledged, THE PARTIES AGREE AS FOLLOWS:

Recitals True

1. The foregoing recitals are accurate and true.

Definitions:

Personal Confidentiality Agreement Template

source: rvh.on.ca

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