HIPAA Acknowledgment for Foundation Staff

NEW OR ANNUAL RENEWAL FOR UNIVERSITY OF NEBRASKA FOUNDATION STAFF 

CONFIDENTIALITY AND PROPRIETARY ACKNOWLEDGMENT REGARDING PRIVACY AND SECURITY

I acknowledge that the University of Nebraska Foundation’s (“Foundation”) donor databases and related paper and electronic resources (“Protected Information”) are confidential and proprietary. Protected Information is also the property of the Foundation and/or its Affiliates, including the University of Nebraska-Lincoln Alumni Association, University of Nebraska at Omaha Alumni Association, University of Nebraska at Kearney Alumni Association, University of Nebraska Medical Center Alumni Association and The Nebraska Medical Center (“Affiliate”; or collectively as “Affiliates”).  If I access this information, I agree to abide by the following terms:

  1. Protected Information is and shall remain confidential and proprietary.
  2. Protected Information is and shall remain property of the Foundation and/or appropriate Affiliate.
  3. I agree I will only access the Protected Information I need for my role as an employee of the Foundation (“Advancement Purpose”). I understand if I encounter Protected Information beyond my Advancement Purpose, I will disregard the extraneous Protected Information.
  4. I agree to maintain all electronic devices I use to access the Protected Information in a secure manner that does not compromise the confidential and proprietary nature of this Protected Information or permit access by any unauthorized third party.
  5. I agree that I shall not disclose to any unauthorized third party, or use for personal gain, any Protected Information acquired from the Foundation or Affiliate.
  6. I understand that access to Protected Information is a privilege and that unauthorized disclosure of Protected Information may be grounds for termination of this privilege, in addition to civil or criminal legal actions under local, state or federal law.
  7. I understand that my access to Protected Information will be monitored to ensure my use of it is appropriate and within the scope of my Advancement Purpose.