AGH System Access and Confidentiality Form

All outside vendors must read and accept our
terms and conditions before applying for VPN or Cerner access



As a condition to my association with Abbeville General Hospital (“AGH”), I agree to maintain the confidentiality of AGH’s confidential and proprietary information, including but not limited to:


  1. Patient information, including demographic, health, and financial information.
  2. Private information about members of AGH’s workforce (e.g., employment records, Social Security numbers, dates of birth, banking information, home addresses, and telephone numbers).
  3. AGH’s proprietary and confidential information (e.g., patient lists, trade secrets, professional fees, reimbursements, computer systems technology, profit and loss data, financial data, vendor/third party contracts, and strategic and business plans).

As a condition to my access to AGH’s information systems and my association with AGH, I agree to the following conditions:


  1. I am responsible for protecting the confidentiality of patient and employee information and records, and shall not use or reveal any such information outside the context of my duties with AGH. I understand that such information must be and will be held in the strictest confidence, and I agree that I will not at any time during or after my affiliation with AGH disclose any information without proper legal authority.
  2. I recognize my role in maintaining confidentiality encompasses protection of records and all documents containing sensitive information. It also includes restricting all conversations related to sensitive information to a person with the right to know in areas not accessible to the public.
  3. I understand that AGH has a right to monitor data and information that are stored or communicated via the AGH network and systems to ensure that all applicable laws and AGH policies are followed. As such, I understand that, except as otherwise stated herein, there is no expectation of privacy on my part for any device that is connected to the AGH network or systems or for any access to/from such systems.  I also understand that all access may be monitored on the AGH network.
  4. I agree only to access patient, financial, and/or other AGH business-related information needed for the performance of my duties and responsibilities.
  5. I understand that applications are available outside the AGH network via various remote access methods (i.e., VPN, EMR access, and/or Web), and I agree to abide by the following when accessing AGH’s computer systems from remote locations:
    1. I will only access AGH computer systems from remote locations if I am authorized to do so.
    2. I will use discretion in choosing when and where to access AGH computer systems remotely in order to prevent inadvertent or intentional viewing of displayed or printed information by unauthorized individuals.
    3. I will use proper disposal procedures for all printed materials containing confidential or sensitive information.
    4. I understand that if I choose to use my personal equipment to access AGH computer systems remotely, it is my responsibility to provide internet connectivity and virus protection appropriately, and to install any necessary software/hardware. AGH is not responsible if the installation of software necessary for accessing AGH computer systems remotely interferes or disrupts the performance of other software/hardware on my personal equipment.
    5. I understand that by using my personal equipment to access AGH computer systems that my computer is an extension of the AGH network while connected, and is therefore subject to the same rules and regulations that apply to AGH-owned equipment.
  6. I will not release my user ID or password to any other person, including any employee or person acting on my behalf. I will not allow anyone else access to AGH’s network or systems. I agree to notify AGH immediately if I become aware or suspect that another person has accessed my user ID and/or password.
  7. I agree to log out of AGH’s network before leaving my workstation to prevent others from accessing AGH’s network.
  8. I will not make any unauthorized copies of data obtained via AGH’s network/systems, and I will not save confidential information to portable devices (e.g., laptop computers, ZIP drives, PDAs, CDs, or other devices).
  9. I will not access data on AGH’s network/systems for “curiosity viewing.” This includes viewing data related to my family members, friends, coworkers or other person of interest unless necessary to provide services to a patient or for legitimate business purposes.

I understand that I must sign this Agreement as a precondition to issuance of a computer password for access to the AGH network and/or patient information and that failure to comply with the preceding provisions will result in formal disciplinary action, which may include, but will not be limited to, termination of access, termination of employment in the case of employees, termination of agreements in the case of contractors, or revocation of clinical privileges in the case of medical staff members, taken in accordance with applicable medical staff by-laws, rules and regulations.

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