ALBOUM & ASSOCIATES LLC
DBA ALBOUM TRANSLATION SERVICES

The above Organization Name will be referred to as “Organization” throughout the document.

I understand that organization and its clients have a legal responsibility to protect patient privacy. To protect patient privacy, the organization must keep patient information confidential, and must safeguard the privacy and security of patient information.

I understand and acknowledge that “Confidential Information” includes, but is not limited to, protected health information (PHI), electronic protected health information (ePHI), any information about patients or employees, any computer login codes or passwords, any patient record or billing information, any patient lists, any financial information about organization or its patients that is not public, any intellectual property rights of organization and any information that concerns organization’s contractual relationships, or that is otherwise designated as confidential by the organization.

In addition, I understand, that during the course of my performing services for organization, I may see, hear, touch, or encounter such confidential information. Regardless of the capacity in which I work, whether I am an employee, a linguist, a sales representative, building maintenance, or general laborer, I understand that I must sign and comply with this agreement in order to be allowed to work with or access the data of organization.  By signing this agreement, I understand and agree that:

1. As a vendor with indirect contact with confidential information (including, but not limited to, PHI or ePHI), I will keep patient information confidential. I will neither share nor discuss that information with others.

2. As an employee or contractor that works directly with confidential information (including, but not limited to, PHI or ePHI), I will disclose such information only under the conditions lawfully set forth by the Privacy Officer(s). With respect to other types of sensitive information, I will keep such information confidential and will only disclose such information if it is required for the performance of my job and after receiving the permission of the Privacy Officer(s).

3. As an employee, contractor, or as someone with indirect access as a vendor to confidential information (including, but not limited to, PHI or ePHI), I will not discuss any information that is either patient-related or operations-related in public areas, even if the information does not or cannot identify a patient (i.e., even if the information is not individually identifying health information). I will not conduct my work in a public area, unless that public area is an essential place for the performance of my job. In addition, I will keep all security codes and passwords used to access the facility, equipment or computer systems, confidential at all times.

4. As an employee, contractor, or as someone with indirect access as a vendor to confidential information (including, but not limited to, PHI or ePHI), I will only access or view patient information for activities I must perform to do my job. If I have any questions about whether access to certain information is required for me to do my job, I will immediately ask the organization’s Privacy Officer for assistance.

5. As an employee, contractor, or as someone with indirect access as a vendor to confidential information (including, but not limited to, PHI or ePHI), I will not disclose, copy, transmit, inquire about, modify, or destroy patient information or other confidential information without permission from the Privacy Officer. This information includes transmissions made by or from organization(s) to my home or any other location than the organization(s’) site.

6. As an employee, contractor, or as someone with indirect access as a vendor to confidential information (including, but not limited to, PHI or ePHI), once my services with the organization are terminated or completed, I will immediately return all property to the organization. This property includes, but is not limited to keys, access cards, organization documents however stored or maintained, and ID badges.

7. Even after my job or access as a vendor is terminated, I agree to meet my obligations under this agreement.

I understand that violation of this agreement may result in disciplinary action, up to and including termination of my employment or relationship with the organization, and that this action may include civil and criminal legal penalties.

I have read the above agreement and agree to comply with its terms at all times specified in the agreement.

Printed Name: 

 

Date: October 18, 2026