Fillable Dental Assisting Confidentiality Statement (Indian Hills Community College)

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Dental Assisting Confidentiality Statement (Indian Hills Community College)

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Confidentiality Statement
Dental Assisting Program
Throughout the Dental Assisting Program at Indian Hills Community College,
I, ______________________________, will have access to patient information. I realize that this information
is private and protected under HIPAA and HITECH Act 2009 and should be kept confidential. I realize that any
unauthorized release of information is punishable by fine and/or imprisonment or dismissal from the program.
Throughout my education in the Dental Assisting Program at Indian Hills Community College, I will not at any time
inappropriately release confidential information and I will adhere to the Code of Ethics of the Dental Assisting
Program.
I understand that release of unauthorized patient information will result in immediate termination from the Indian
Hills Community College Dental Assisting Program.
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Dental Assisting Confidentiality Statement (Indian Hills Community College)

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Completed 19 July 2020

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