HIPAA Employee Confidentiality Agreement

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Updated December 14, 2021

A HIPAA employee confidentiality agreement requires an employee with access to protected health information (PHI) to not share that information with a third party. This is used when an employee will have access to a database or any health records of individuals.

The Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 requires that covered entities with access to individual’s protected health information (PHI) maintain the confidentiality of the sensitive personal and medical information. The purpose of the rule is to ensure that medical information remains protected while allowing the flow of information required to provide the highest level of healthcare.

Laws – 45 CFR Part 160 & 45 CFR Part 164

Related HIPAA Forms

How to Write

Step 1 – Download in Adobe PDF, Microsoft Word (.docx), or Open Document Text (.odt).

Step 2 – The date the agreement is being entered into can be supplied first. The name of the Healthcare Facility and the name of the Employee will also be needed.

Step 3 – The State whose laws will govern the agreement must be specified.

Step 4 – The date, signature, and printed name of the employee are needed at the bottom of the form.