Volunteer Confidentiality Agreement
The Arc of East Central Iowa is legally bound to abide by the Health Insurance
Portability and Accountability Act (HIPAA). In addition, The Arc is ethically obligated to
abide by Federal and State Confidentiality Laws. Any individual who volunteers with
The Arc of East Central Iowa is responsible for maintaining the confidentiality of both
the consumers and employees of the agency throughout the duration of their volunteer
time and following separation from The Arc.
All information concerning a consumer and his/her family as well as an employee of The
Arc is confidential and should not be shared with anyone other than Arc supervisory
staff or a relief staff with a specific need to know. This includes, but is not limited to,
sharing information about one family with another family, having consumer or employee
documents where others can see them, or indicating that a family receives services
through The Arc.
The very fact that an individual is served or an individual is an employee must be kept
private and confidential.
It is important to note that a consumer’s or employee’s right to confidentiality is not
absolute if one or more of the following criteria are established: the individual poses an
immediate danger to themselves or to another designated individual.
The Arc requires that all volunteers sign this Confidentiality Statement as a condition of
their volunteer status. Should an occasion arise in which the volunteer is unsure of
obligations under this policy, it is their responsibility to consult with the person who is
supervising their volunteer experience.
I hereby acknowledge that I have read and understand the aforementioned information
regarding consumer and employee confidentiality. I agree to adhere to the HIPPA and
Confidentiality requirements of The Arc of East Central Iowa both during and upon
completion of my volunteer time.
Volunteer Full Legal Name (Printed):