As interns, it is imperative to uphold strict confidentiality standards regarding all information concerning Scotland County Health Department (SCHD) patients and clients. Throughout your interactions at SCHD, you may come across information from various sources such as staff, patients, clients, or external partners. It is strictly prohibited to discuss or disclose this information to anyone who does not have a legitimate need to know. Sharing confidential information, whether verbally or electronically, with neighbors, friends, or relatives is strictly prohibited.

In the event that you are approached by the media or requested to speak to them, it is essential that no information regarding SCHD patients or clients is disclosed. While discussing the positive aspects of your internship experience, it is imperative to prioritize confidentiality and refrain from sharing any names or other confidential details. Additionally, it is strictly prohibited to provide or allow the media to take pictures of patients or clients. 

Moreover, I authorize SCHD to reproduce pictures or news articles regarding my internship or volunteer program, provided they do not contain confidential information. 

In certain situations, you may encounter Protected Health Information (PHI). It's essential to recognize that federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA), safeguard the confidentiality of PHI.

PHI encompasses any information identifying an individual and pertaining to their past, present, or future physical or mental health status, or the provision of healthcare services to them.

I acknowledge and agree to maintain strict confidentiality regarding all sensitive information, particularly Protected Health Information (PHI) pertaining to SCHD patients and clients. I am aware that any breach of this confidentiality will lead to termination of my participation in the internship experience, and may also subject me to legal consequences

Dress Code Policy Acknowledgment

I have been informed about the content, requirements and expectations of the Dress Code Policy for volunteers and interns. I agree to abide by the policy guidelines as a condition of my clinical rotation, internship or volunteer program. I further understand that if I have questions at any time regarding the Dress Code policy or any other policy that governs SCHD, I will consult with my immediate preceptor, department coordinator, supervisor or department Human Resources representative. 

Risk and Consent Form

I understand that there are certain dangers, hazards and risks associated with my participation in the internship activity(s) described above. I further understand that all risks cannot be prevented. I have considered the risks associated with participating in this internship and knowingly and voluntarily assume all said risks. 

I hereby agree to indemnify, hold harmless, release from liability and waive any legal action against Scotland County Health Department, its governing board and employees for any personal injury, death, or property damage I may suffer. I represent that I am covered by adequate medical/health/accident insurance for any injury that I may suffer at the internship site. In the event I require medical services due to an injury suffered during the internship, I understand and agree that Scotland County Health Department is under no obligation to provide transportation for me to obtain medical services. 

Safety Orientation:

Please watch the following YouTube video on Health Care safety in the workplace.

I have watched the above video on healthcare safety and understand the hazards I may encounter.  If I have questions or concerns about these hazards, I will discuss them with my internship site coordinator, the agency Safety Officer or the Health Director.