table of contents - UWA Athletic Training & Sports Medicine Center
table of contents - UWA Athletic Training & Sports Medicine Center
table of contents - UWA Athletic Training & Sports Medicine Center
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CONFIDENTIALITY STATEMENTforATHLETIC TRAINING STUDENTSI, , understand that information inthePlease Print Full Name<strong>of</strong>fices <strong>of</strong> the <strong>Athletic</strong> <strong>Training</strong> Facility and the <strong>Athletic</strong> Department <strong>of</strong> The University <strong>of</strong> WestAlabama is confidential and may not be divulged to anyone except the person who owns theinformation, those faculty, staff, or administrators who have need to know and those individualsor agencies who fulfill the requirements under the Federal Educational Rights and Privacy Act <strong>of</strong>1974 at http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html , as amended (FERPA) and theHealth Insurance Portability and Accountability Act (HIPAA) athttp://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/HIPAAGenInfo/Downloads/HIPAALaw.pdf . If I release confidentialinformation or discuss confidential information outside <strong>of</strong> the <strong>of</strong>fice, I understand that I will beimmediately discharged from the <strong>Athletic</strong> <strong>Training</strong> Program.I have read the above statement and agree to maintain the confidentiality <strong>of</strong> all information that Ihave access to through this <strong>of</strong>fice.<strong>Athletic</strong> <strong>Training</strong> Student SignatureDateWitness SignatureDate53