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confidentiality contract

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									Gallaudet University

Confidentiality Contract
Student Academic Center, Room 1221

As an employee at TIP you need to be aware that much of the information received in our office is confidential and CANNOT be shared outside this office. There are established policies and procedures for the accumulation and custody of confidential information at Gallaudet. All student records and other information received and stored at TIP should never be improperly used or released to an unauthorized person. If you have a question regarding whether or not to release information to an individual, please ask your supervisor. By signing this agreement, you agree to uphold TIP’s Confidentiality Policy. This means you will not share student information with ANYONE. Examples of confidential information are: • Student Grade Reports • Student Transcripts • Student Tutoring Files • Complaints from students, faculty and staff • Tutorial/Advising sessions • Mail • Attendance at TIP • Personal information • Disabilities • Any information from University or TIP databases. • Any other office-related issues I understand that I may have access to confidential information and that it is my responsibility to maintain the integrity of this information and to keep it private. I further understand that disclosure of confidential information will result in disciplinary action (i.e. termination of employment). _________________________________________________ PRINT NAME of TIP Employee _________________________________________________ Signature of TIP Employee and Today’s Date _________________________________________________ Signature of TIP Supervisor and Today’s Date

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