PLEDGE OF

CONFIDENTIALITY

This is to certify that I,

(Name) dr. Maria Clemensiana Baba

(Affiliation) RS.Wahidin Sudiro Husodo Makassar
(Title) Doctor
understand that any patients' personal information obtained
in the conference must remain confidential.

understand that any kind of activities that threaten any confidentiality

obligation (i.e. recording or doing caption ofimages) are prohibited.

lunderstand that any unauthorized release or carelessnessin the

handling of this confidential information is considered a breach of the
duty to maintain confidentiality.

furtherunderstand that any breach of the duty to maintain

I
confidentiality could be possible liability
in
anylegal action arising from
such breach.

Signature

Date 5/3/2023