AT Program Confidentiality and Privacy Agreement
Cumberland University Athletic Training Program Confidentiality and Privacy Agreement I, _________________________________________, understand the importance of confidentiality while working or observing at any of the on-campus and off-campus sites for Cumberland University’s Athletic Training (AT) Program. I will not discuss any patients and/or athletes that I may observe. I also understand that discussion of athletic related cases related to my educational experience in my courses is not to be discusses outside the confines of my clinical educational experience. I understand that breaking confidentiality is a violation of professional ethics and may result in a grad deduction, reprimand, recommendation of probationary terms, or removal from the assigned preceptor. Print Name: ___________________________________________ Signature: ____________________________________________ Date: ________________________________________________ Witness: _____________________________________________ *This signed document will be kept in the student’s personal file.