Copyright © 2018 NonDisclosure.com. All Rights Reserved.
VISITOR NON-DISCLOSURE AGREEMENT
I understand that for safety and legal reasons, all information about anyone who seeks or has
received the services of must be kept confidential. This includes any products or services that
could be considered proprietary information.
This also includes the identity of those who seek services, their names, gender, age, number
of children, addresses, types of services received, and place where the services were
requested or received, and any other information that could identify the individual. I
understand that this information is NOT to be shared with anyone including any private or
public institutions.
I will maintain the confidentiality of those people I meet at __________________________,
(“establishment”) including the identities or personal details of any staff, volunteers, or
patrons.
Also, because of significant security issues, I understand that the establishment’s location
must be kept confidential.
I understand that my confidentiality obligation is on-going and it does not end when upon
termination of my relationship with this establishment.
I agree to abide by the guidelines above. I understand that failure to respect these
confidentiality guidelines may result in me being barred from the establishment along with
legal action if needed. Depending upon the impact of my confidentiality breach, I may also be
subject to civil or criminal liability. This Agreement was created to ensure the safety and
privacy of service patrons, staff, and volunteers. I agree to notify an administrator
immediately if I have questions or concerns regarding this Agreement.
Visitor Signature ____________________________
Visitor Printed Name _________________________ Date: ___________
