Certificate of Completion


Confidentiality Agreement:

Each person who works, advises, volunteers, is privileged or is otherwise authorized to engage in the care of patients at Childrens Hospitals and Clinics of Minnesota (Childrens) is required to ensure confidentiality of information. This requirement applies to all aspects of interactions at any Children's facility or function. Confidentiality must be maintained with respect to past, present, and future information obtained by any means oral (heard or discussed), paper (faxes, documents), and electronic (computer, PDA). Confidentiality extends to appropriate use of computer systems. Computer equipment and applications may be reviewed randomly for license compliance (all software licenses are to be filed with IT Services), system maintenance and/or appropriate use.

The obligation to maintain confidentiality pertains especially, but is not limited, to the following:
  • Patient and family information
  • Information from the medical record all requests for copies of the medical record are to be referred to Data and Record Services
  • Peer review related information
  • Business information, organizational documents and other sensitive information
  • Media communication - need to be referred to the Communications Department
  • In consideration of your association with Childrens and its affiliated entities, you (and your associates) agree, that during this time period and thereafter indefinitely, you shall not allow disclosure, directly or indirectly, of confidential information obtained by any means, except where disclosure is required as part of your job or association, required by law, or expressly allowed by the written approval of Childrens.
  • Furthermore, you agree that, at the end of this association, you shall promptly return to Childrens any and all confidential information disclosed to you that is written, electronic or in other form. You will continue to hold confidential any unwritten or oral information subject to the terms of this agreement.
  • I understand any violation of this agreement may result in appropriate action.
* : I have read the above statements and agree to abide by the obligations of confidentiality in regard to any and all information.
* Name:
* Agency:
* - Required Fields

Hitting "Submit" will generate an email to Interpreter Services and populate a certificate for your records.
Please save a copy for your own records and provide your agency with a copy as well.