Commitment to Confidentiality to students

D.…………………………………………………………………………………………………………………………………………….
with DNI/NIF/NIE …………………………….……. has the status of personnel in training students at
the Health Center contract ……………….……………………………………………………………….………. such as:

 University student in Bachelor

PHYSIOTERAPY NURSING PSYICHOLOGY

 Graduate/Research students

MASTER PhD DEGREE RESEARCH

Declares that:

1. Recognizes that patients have the right to respect for their personality, human dignity
and privacy and the confidentiality of the information related to its process.
2. Also recognizes that patients are entitled to the respect the confidential nature of the
data relating to your health, and that no one can access them without prior
authorization.
3. In accordance with article 10 of the Organic Law 15/1999, of December 13th, of
protection of data of a Personal nature, recognizes that it has a duty to maintain
secrecy with respect to the information that goes into the development of its activity
committed to providing the utmost care and confidentiality in the handling and
safekeeping of any information/documentation during its formative period and once
concluded the same.
4. Recognizes that not necessary transfer, duplicate or reproduce all or part of the
information to which it has access on the occasion of its activity in the heart, not being
able to use the data provided by the same for other than training purposes, or those of
others for which authorized by the management of the Centre.
5. Knows and accepts the Protocol by which determine the basic guidelines intended to
ensure and protect the right to privacy of the patient by the students of the health
sciences-related.
6. Is aware that is responsible for staff abide by the duty of confidentiality and that non-
compliance may have criminal, disciplinary or even civil consequences.

Therefore, commits to his conduct at the Health Centre fits as provided in the preceding
paragraphs of this responsible statement, which was signed in duplicate,

In ……………………………., at…………… of ………………… of …………………

Signed:

Universidad Camilo José Cela Sample Health Center Sample