JCU Division of Tropical Health and Medicine_Version 2_1 September 2018
Surname Given Names
Student Number Discipline
I acknowledge that whilst I am undertaking Professional Experience Placement as part of my course I will have access to condenal and
personal informaon about paents/clients.
As a student enrolled at James Cook University I understand the obligaon of condenality of informaon concerning the personal aairs
and health related informaon of paents/clients.
I will not at any me disclose any Condenal Informaon or Personal Informaon relang to a paent/client of a placement facility that I
become aware of unless the disclosure of the informaon:
(a) is necessary to enable a health professional or me to perform health care dues; or
(b) is for the purpose of obtaining legal advice from a registered legal praconer; or
(c) is required pursuant to an order of a Court, Commission or Tribunal; or
(d) is in accordance with the Privacy Act 1988 (Cth) or the Informaon Privacy Act 2009 (Qld).
I will not disclose any private or commercial informaon (e.g. relang to other sta or the placement facility) that I become aware of
(regardless of how obtained) during a Professional Experience Placement.
I will not remove from the premises of a placement facility, any wrien or hardcopy documents/les or any electronic les, which belong
to the placement facility, and which may contain Condenal Informaon or Personal Informaon relang to a paent/client of the place-
ment facility or the operaon of the placement facility.
I will not make any record(s), (other than on documents or les which belong to the placement facility), during or aer compleon of my
Professional Experience Placement, which may idenfy any paents/clients of the placement facility. I further undertake not to remove
from the premises of the placement facility any wrien or hardcopy documents/les or any electronic les, (including notes for case stud-
ies and paent/client care plans) which I have prepared during my Professional Experience Placement and which may idenfy a paent/
client of the placement facility. I acknowledge that in order to ensure a paent/client is not idenable; I must not record any of the fol-
lowing details where the recording of one or more of the details would enable the paent/client to be idened:
(a) the name of the paent/client;
(b) inials of the paent/client’s name;
(c) the paent/client’s date of birth;
(d) the paent/client’s date of admission or consultaon at the placement facility;
(e) any names of the paent/client’s relaves;
(f) the name or details of the placement facility; or
(g) the names or details of any of the placement facility’s health professional or administrave sta.
I will not publish on social media (including Facebook, Twier, or any other social media website) any photographs, details or informaon
of any kind, which I have gained or observed during a Professional Experience Placement. I also undertake not to discuss any details or
informaon gained or observed during a Professional Experience Placement which may idenfy a paent/client of the placement facility,
at any JCU lecture or tutorial, JCU event or whilst engaging in any educaonal acvity at any place.
If I am required to access electronic health records during a Professional Experience Placement, I will not share my idencaon number
or password with any other person, and I will log o computer sessions when I am away from a workstaon.
Student Signature
Date
‘Condenal Informaon’ includes, but is not limited to:
(a) informaon which by its very nature might be reasonably understood to be condenal or to have been disclosed in condence;
(b) informaon which a placement facility indicates is condenal;
(c) informaon which relates to any arrangements or transacons between a placement facility and its paents/clients;
(d) informaon which would be of a commercial value to a competor of a placement facility; or
(e) all records based on or incorporang informaon referred to in clauses (a) to (d).
‘Personal Informaon’ is informaon or an opinion about an idened individual, or an individual who is reasonably idenable:
(a) whether the informaon or opinion is true or not; and
(b) whether the informaon or opinion is recorded in a material form or not.
‘Professional Experience Placement’ is a clinical or praccal educaon experience, which is a required component of a course, in a health
or animal service that may be on campus or o campus. It is also known as professional pracce, work-placement, work experience, work-
integrated learning, farm work, praccum, internship, clinical experience, clinical placement, pracce placement or praccal work.
click to sign
signature
click to edit
![]()
