Confidentiality Agreement - Chai Lifeline Canada

Chai Lifeline Canada Branch?*
Name*
Prefix First Last
Email*
As a Chai Lifeline volunteer/staff member, I understand that in the course of my contacts with families served by Chai Lifeline, I might learn privileged and confidential information that is of a highly personal nature. Examples of such information might be, but are not limited to: medical condition and treatment, finances, living arrangements, employment, identifying information and relationship among family members. I understand that all such information must be treated as confidential. I agree not to disclose any information I learn about patients/clients and their family members to anyone, except a Chai Lifeline staff member. I will also make certain that any disclosures are made in a private setting in which no one can overhear any information that is conveyed. I understand unauthorized disclosures are considered grounds for immediate termination of volunteer status. I understand and am willing to honour the time commitment required for my volunteer assignment and accept direction from Chai Lifeline staff designated. I agree to fully review policies and procedures outlined in the Chai Lifeline volunteer manual when issued to me.*
- I agree
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Date*
DD slash MM slash YYYY

36 HOURS.