NON-DISCLOSURE AGREEMENT/UNDERTAKING (FOR STUDENT-AFFILIATE, CLINICAL INSTRUCTORS, PRECEPTORS

AND/OR FACULTY MEMBERS DESIGNED BY THE HEI TO SUPERVISE THE CLINICAL ROTATION OF STUDENTS

CONFIDENTIALITY &NON-DISCLOSURE AGREEMENT

This Confidentiality and Non-Disclosure Agreement, entered into by and between:

CEBU SOUTH MEDICAL CENTER, a National Government Hospital, with office address at San Isidro, Talisay City, Cebu
Philippines, herein represented by its Medical Center Chief II, Agustin D. Agos, Jr., MD, FPSGS, FPCS, DODT, Ph.d.OD, RODC, hereinafter
referred to as “HOSPITAL”;

-and-

_Johannah Ray T. Años of legal age, a BSN - II student, CLINICAL INSTRUCTORS, PRECEPTORS AND/OR FACULTY MEMBERS of
_Cebu Institute of Technology – University_, and with residence address at _Labangon, Cebu City_, hereinafter referred to as the “Trainee” (or
“Clinical Instructor, “Preceptor” or “Faculty Member”, whichever is applicable);

Witnesseth, as follows:

DEFINITION OF TERMS:

1. Proprietary Information- refers to information relating to Patients’ Information, Patient Care Management, such as but not limited to
Diagnosis, Diagnostic Results, Procedures Performed & Medications; the Organization, Management and its Employees’ Information,
and all other information disclosed or may have been disclosed to, or acquired by the trainee, affiliate, clinical instructors, preceptors,
faculty members and to the affiliating school, either directly or incidental to the training or affiliation.

2. Reasonable Disclosure- refers to disclosure for purposes agreed upon by the herein parties, such as:

a. Preparation of documents and performance of acts necessary to accomplish the services provided to
the Patient/s;

b. Use of the Patient’s personal data and medical record such as but not limited to Laboratory and
Imaging Results for Case Presentation Purposes within the HOSPITAL and which are necessary to the
Patient Care Management or to check or evaluate the learning of the Trainee;

c. Student, intern, senior clerk, or trainee’s Compliance to the Board Exam Application Requirements set
by the PRC and other Professional Regulatory Bodies, provided that no sensitive personal information
of patient shall be divulge unless prior consent from the Medical Center Chief has been secured;

d. All other purposes provided the same has been approved by the Hospital’s Medical Center Chief.

3. Sensitive Personal Information- as used in this Agreement, sensitive personal information refers to information as defined under the
Data Privacy Act of 2012.

OPERATIVE PROVISIONS

1. In consideration of the disclosure of Proprietary Information by the HOSPITAL, the Trainee (or “Clinical Instructor, “Preceptor”
or “Faculty Member”, whichever is applicable) hereby agrees: (i) to hold perpetually the Proprietary Information in strict
confidence and to take all reasonable precautions to protect such Proprietary Information (including, without limitation, all precautions
the HOSPITAL employs with respect to its own confidential materials), (ii) not to disclose perpetually any such Proprietary
Information or any information derived therefrom to any third person, except for reasonable disclosure as defined above, (iii) not to
make any use whatsoever at any time of such Proprietary Information except for purposes allowed by the HOSPITAL, and (iv) not to
copy or reverse engineer any such Proprietary Information. In the event of data breach, as defined under the Data Privacy Act of
2012, the Trainee” (or “Clinical Instructor, “Preceptor” or “Faculty Member”, whichever is applicable) shall be SOLELY AND
EXCLUSIVELY liable for such breach.

2. Immediately upon the end of the affiliation/training period, the Trainee (or “Clinical Instructor, “Preceptor” or “Faculty
Member”, whichever is applicable) will return to the HOSPITAL all Proprietary Information and all documents or media
containing any such Proprietary Information and any and all copies or extracts thereof, without the need of any demand from the
HOSPITAL.

3. The Trainee (or “Clinical Instructor, “Preceptor” or “Faculty Member”, whichever is applicable) further acknowledges and
agrees that no representation or warranty, express or implied, is or will be made, and no responsibility or liability is or will be accepted
by the HOSPITAL, or by any of its respective directors, officers, employees, agents or advisers, as to, or in relation to, the accuracy
of completeness of any Proprietary Information made available to the Trainee or its advisers; the Trainee or its advisers is responsible
for making its own evaluation of such Proprietary Information.

4. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of
such rights. If any part, term or provision of this Agreement is held to be illegal or unenforceable neither the validity, nor
enforceability of the remainder of this Agreement shall be affected. Neither Party shall assign or transfer all or any part of its rights
under this Agreement without the consent of the other Party. This Agreement may not be amended for any other reason without the
prior written agreement of both Parties. This Agreement constitutes the entire understanding between the Parties relating to the subject
matter hereof unless any representation or warranty made about this Agreement was made fraudulently and, save as may be expressly
referred to or referenced herein, supersedes all prior representations, writings, negotiations or understandings with respect hereto.

5. This Agreement shall be governed by the laws of the Republic of the Philippines and the parties agree to submit disputes arising out of
or in connection with this Agreement to the proper courts of Talisay City, Cebu Philippines, to the exclusion of all others.
 Signed this _24th of January 2023_ at _Cebu City_, Philippines by:

______JOHANNAH RAY T. AÑOS_____ DR. AGUSTIN D. AGOS, JR.

Trainee/Clinical Instructor/Preceptor/ Medical Center Chief
Faculty Member

Signed in the presence of:

____________________________________ DR. JOANNES PAUL MIRANDA

ACKNOWLEDGMENT

Before me, a Notary Public for and in the City of _______________________, Philippines, personally appeared the below named persons with their
respective proof of identities, known to me and to me known to be the same persons who executed the foregoing instrument and declared to me that the same is
their free and voluntary act and deed:

NAME/S GOVERNMENT ISSUED IDENTIFICATION CARD

JOHANNAH RAY T. AÑOS

DR. AGUSTIN D. AGOS, JR.

This document consisting of two (2) pages, including the page on which this Acknowledgment is written, is signed by the parties and their witnesses in
each and every page thereof.

Witness my hand and notarial seal.

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