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• <br />ATTACHMENT A <br />Confidentiality Understanding <br />By signing and dating this Confidentiality Understanding, the undersigned Student indicates an understanding of, <br />and agrees to be bound by, a certain Affiliation Agreement between The City of Everett ("Facility") and Idaho <br />State University, on behalf of its Social Work Program ("Program"). <br />As a material part of any consideration that Student provides to Facility in exchange for Facility allowing the <br />Student's clinical education at Facility, Student confirms that any patient information acquired during the clinical <br />education is confidential, and Student at all times must maintain the confidentiality of and not disclose this <br />information, whether during the clinical education or after it has ended. <br />Student further must abide by the applicable rules and policies of both Facility and Program while at Facility. <br />Student understands that, in addition to other available remedies, Facility immediately may remove the Student <br />and terminate the Student's clinical education if Facility considers the Student to endanger any patient, breach <br />patient confidentiality, disrupt Facility's operation, or not to comply with any request by Facility including its <br />supervisory staff. <br />I have read and understand the Affiliation Agreement, and I agree to abide by this Confidentiality Understanding. <br />Student's Signature Date <br />Student's Name (Print) <br />ISU's Program Witness (Signature) Date <br />ISU's Program Witness Name and Title (Print) <br />OGC Approved - NTJR-1.11.23 Page 7 of 7 <br />