General Confidentiality Practices Checklist (Page 3 of 3) in pdf

General Confidentiality Practices Checklist Page 3

Paper Record Security

_____________________

maintains the confidentiality of paper records by:

(Firm or Registry)

Restricting access to data-storage areas, the use of locked file rooms or cabinets in limited-access

areas, a forms tracking log for any external disclosures, and a sign-out system for internal use of

data.

Development and implementation of policies by institutions for the secure transport of information

from one physical location to another.

Assuring confidentiality of written evidence that a patient is on a specific research study; for

example, logs or lists of screened individuals or participants should not be left out on desks or in

other open-access areas.

Safeguarding of ancillary records, e.g., pharmacy records, data on patients screened for clinical

trials participation, etc.

Situating FAX machines in secure or limited-access areas; use of pre-coded phone number to

eliminate dialing errors; cover sheets so data are not physically exposed; testing FAX machines to

insure correct number and function; and de-programming FAX memory storage after use to

prevent recovery of confidential information.

Employing established shredding procedures for disposal of documents after use.

Hardcopy information of sensitive information sent outside of the department is protected.

Re-release of ___________

Data Files

(Registry)

_____________

does not release any ____________

data files to any one without

(Firm or Registry)

(Registry)

written consent of the Registry Director or designee.

A written consent is required every time a data request is received, even if the requester has obtained

previous approval or if new data are added to a data file that was previously approved for release.

Signature

Typed Name

Title

Date

Inventory: Security and Confidentiality

3 of 3

As of 04/09/2002

General Confidentiality Practices Checklist Page 3