Place original signed copy of this Agreement in the Medical Student's file.
Effec. Date 8/17/04
C:\Data\StudentRegistration05\A 3 5 a Conf Agr Med Students.doc
CONFIDENTIALITY AGREEMENT FOR STUDENTS
I understand that I may come in contact with various types of information in my studies or
through engaging in my academic program at Johns Hopkins. This information may include,
but is not limited to, information on patients, employees, plan members, students, other
workforce members, donors, research, and financial and business operations. Some of this
information is made confidential by law (such as “protected health information” or “PHI” under
the federal Health Insurance Portability and Accountability Act) or by Johns Hopkins policies.
Confidential information may be in any form, e.g., written, electronic, oral, overheard or
observed. I also understand that access to all confidential information is granted on a need-
to-know basis. A need-to-know is defined as information access that is required in order to
engage in my studies or to complete my approved academic requirements program at
Hopkins. If my course of study changes, my need to know also may change.
I will protect the confidentiality of all confidential information, including PHI, while at Johns
Hopkins. I will not share PHI with those outside of Hopkins unless they are part of my studies
or educational program at Johns Hopkins. I will not remove any confidential information from
Johns Hopkins except as permitted by Johns Hopkins policies or specific agreements or
arrangements applicable to my situation.
If I knowingly violate this agreement, I will be subject to expulsion from my studies or
educational program at Johns Hopkins. In addition, under applicable law, I may be subject to
criminal or civil penalties.
I have read and understand the above and agree to be bound by it. I understand that signing
this agreement and complying with its terms is a requirement for my studies or enrollment in
an educational pr