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7 Free Medical/Patient Confidentiality Agreement Templates

The patient Confidentiality Agreement template is key to the preservation of trust between patients and their doctors. The moral basis is consequentialist, as it is meant to improve patient welfare. There is a broad communitarian public interest in the protection of confidences; hence, preservation of confidentiality is imperative to secure public health. Failure to uphold this venerable obligation may result in suboptimal treatment. For many years, doctors have upheld this ethical principle enshrined in the Hippocratic Oath that has been published by the international community assenting to the Declaration of Geneva.

The practice of all professional doctors in the world is subject to the regulatory authority of the General Medical Council (GMC) who dearly uphold this professional obligation. The British Medical Association (BMA) advises all professional doctors to consider the benefits of breaching patient confidentiality against the grave consequences of damaging their professional relationship and risking public trust in what should be a confidential service.

However, medical confidentiality is not entirely absolute in modern medical practice. There are special circumstances when there is a need to breach this obligation. The legitimate exceptions for authorized breach are specified by the GMC’s professional code of conduct:

  • Disclosure with consent;
  • Disclosure in the public interest;
  • Disclosure is required by law.

The obligation of patient confidentiality goes way beyond undertaking not to divulge confidential information; it includes a responsibility to ensure that all/any records that contain patient information are well kept in a secure location.

Patient Confidentiality Agreement Templates

How to Draft a Patient Confidentiality Agreement Template?

Before drafting your patient confidentiality agreement template, it is important that you first consult a legal or a medical expert to get insight into the right way of drafting the patient confidentiality agreement template. Make sure to include all information that you would like to designate as confidential. However, there is no need to add in any details which you have no intention of sharing with the person signing the agreement. Break the contents into small, easy-to-read paragraphs to enhance readability. You can also see the Basic Confidentiality Agreement to see the general structure of a patient confidentiality agreement template and the use of the sample provided to help you in drafting your patient confidentiality agreement template.

Contents of an Patient Confidentiality Agreement Template

Basic contents of the patient confidentiality agreement template include:

  • Identification of the parties involved
  • Definition of what is to be considered as confidential
  • The stretch of the confidentiality obligation
  • What is to be excluded from confidentiality
  • The terms of the contract.

Benefits of having a Medical Confidentiality Agreement Template

  • The medical practitioner/the medical facility can draft the patient confidentiality agreement template keeping in mind its needs and preferences
  • The agreement gives the person signing it a clear idea as to what type of information is designated by the facility as confidential
  • The agreement also spells out the consequences in case the party signing the agreement breaches it.
  • A patient confidentiality agreement template can be used as valid proof in a court of law

Free Samples

Here are free patient confidentiality agreement templates that are editable and can be customized as per needs:

Patient-Confidentiality-Agreement-1

Patient-Confidentiality-Agreement-2

Patient-Confidentiality-Agreement-3

Patient-Confidentiality-Agreement-4

Patient-Confidentiality-Agreement-5

    non disclosure agreement sample pdf

    simple confidentiality agreement template

      free confidentiality agreement template

      free printable confidentiality agreement form

        Uses of Medical Confidentiality Agreement

        Confidentiality is considered as the central trust between doctors, and their patients, and doctors are held responsible by professional bodies for protecting a patient’s confidential information that the patients share with them.

        An unauthorized or unjustifiable breach of patient confidentiality is usually taken very seriously by the Council, which sets out detailed guidance on the circumstances under which patient information may be disclosed to third parties. The principles that should be applied include:

        1. All patients have a right to demand that any confidential information about them will be held in confidence by their health practitioners. Confidentiality is key to trust between patients and practitioners. Without assurances about confidentiality, the patient may be reluctant to provide the practitioner with the information they require to provide good care.

        2. Should the health care practitioner be asked to provide information about their patients, they should:
          • seek permission from the patient to disclose information whenever possible; this is important whether or not the patient can be recognized from the information you are looking to share; Comprehensive information should be availed to patients with regard to the potential for a breach of confidentiality with ICD10 coding.
          • Keep disclosure of confidential information to the minimum if possible
          • Anonymize data where unidentifiable data is enough to serve the purpose.

        3. Should a health practitioner disclose any confidential information, they should always be ready to justify their decisions to do so in accordance with these guidelines.

        Instances in which Disclosure of Patient’s Information is Either Permissible or Mandatory

        • To comply with a court order
        • To meet the terms and conditions/requirements of a statutory provision, for example. Notification of a communicable disease
        • If the patient has allowed for their information to be disclosed
        • Due to the public interest -which includes, but is not limited to, situations when the individuals affected or the patient would be prone to harm due to risk-related contact
        • If the parent or the guardian consent to disclosing the information of a minor under the age of 12 years
        • If the next of kin or the executor of the state of a deceased patient allows in writing the disclosure of confidential information.

        Frequently Asked Questions

        Is there any Legal consideration for disclosure of a patient’s confidential information?

        A choice on Termination of Pregnancy Act, 92 of 1996, section 7.
        Records of a patients’ termination of pregnancy have to be made by the practitioner and the individual who is in charge of the facility. The individuals in charge of the facility must inform the Director-General of the same within one month of the termination, but the information must be de-identified.

        “the identity of the woman who has requested or obtained a termination of pregnancy shall remain confidential at all times unless she herself chooses to disclose that information.”

        “Every child has the right to confidentiality regarding his or her health status and the health status of a parent, caregiver, or family member, except when maintaining such confidentiality is not in the best interest of the child.”

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