St. Thomas Hospice
Volunteer Confidentiality Agreement

As a St. Thomas Hospice Volunteer and as a member of the Hospice Interdisciplinary team, I will be exposed to confidential information. I understand that the only appropriate place to share specific information is with members of the hospice team.

I recognize that the patient's name and/or any information about him/her and his/her family is also confidential. Therefore, I will not reveal any information that could lead to the identification of the patient or family.

I understand that I may not discuss my patient with my significant other, friends or family, research requests or other hospice volunteers not assigned to that patient.

I understand that a breach of confidentiality may be sufficient reason for termination as a volunteer.

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© 2000 St. Thomas Hospice
Published here with permission.