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SGH SGH Non-Disclosure Form

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26 views4 pages

SGH SGH Non-Disclosure Form

Uploaded by

MuhdDzaki
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NON-DISCLOSURE & SECURITY AWARENESS UNDERTAKING

FOR EXTERNAL USERS AT SINGAPORE GENERAL HOSPITAL PTE


LTD (SGH) (“Undertaking”)

Details of External User:

Name :
NRIC No. / Passport No. :
Job Title :
MCR Number (where applicable) :
Project Title (where applicable)
Work Scope :
Institution / Hospital :

DEFINITION OF EXTERNAL USER:

For the purposes of this Undertaking, an external user shall refer to any person not
employed by SGH, who visits or uses any of the SGH premises and/or its related
companies, to engage in studies, training, programmes, experiments, including but not
limited to visiting / attachment personnel, local or overseas medical students, and visiting
fellows and doctors from the following coordinating bodies:
(a) The Associate Dean’s Office
(b) The Postgraduate Medical Institute
(c) Nursing Administration
(d) The Postgraduate Allied Health Institute
(e) The Division of Research
(f) Chairman of Medical Board Office
(g) Human Resource Division / Learning Centre

(hereinafter referred to as “External User”).

DEFINITION OF CONFIDENTIAL INFORMATION

For the purposes of this Undertaking, confidential information shall mean all information in
any form and on any medium relating to SGH or its related companies, disclosed to or
obtained by the External User, from SGH and/or any of its related companies.
NON-DISCLOSURE & SECURITY AWARENESS UNDERTAKING
FOR EXTERNAL USERS AT SINGAPORE GENERAL HOSPITAL PTE
LTD (SGH) (“Undertaking”)

GENERAL CONFIDENTIAL INFORMATION

I agree:

(a) not to use Confidential Information for any purpose other than for the purposes of my
Work Scope as an External User;

(b) not to disclose to any party, Confidential Information without the prior written consent
of SGH;

(c) that I shall only reproduce, duplicate and/or copy such Confidential Information to the
extent that is necessary for the proper execution of my Work Scope as an External
User and shall also take all steps to prevent any reproduction, duplication and/or
copying of the Confidential Information by others. I shall also ensure that such
copies be properly disposed of as instructed by SGH;

(d) Take reasonable care at all times of Confidential Information and to conduct myself
with regard to the care and custody of Confidential Information in such a way as not
to endanger the safety or secrecy of the information;

(e) Not to remove any documents or tangible items containing Confidential Information
from SGH’s premises at any time without prior authorization;

(f) to surrender and return all or any of the Confidential Information and any notes,
memoranda or written record containing Confidential Information including any
copies made, to SGH at any time, upon SGH’s request and/or when I complete my
Work Scope;

(g) that the Confidential Information and all rights therein are and shall remain the sole
and exclusive property of SGH and/or its related companies as the case may be.

CONFIDENTIAL INFORMATION FROM THE ELECTRONIC MEDICAL RECORDS (EMR)

I am aware that where accessing EMR is required as part of my Work Scope, I am required
prior to such access to undergo an orientation programme specific to the protection of the
confidentiality of EMR and to sign an EMR Security and Official Use Self Declaration Form
and such other written undertakings as are required by SGH. I shall not access the EMR
without first giving my undertaking to comply with such requirements.

IDENTIFICATION CARD, PASSWORD AND COMPUTER SECURITY

I am aware that where connecting to SGH’s or Singapore Health Services Pte Ltd’s
(“SingHealth”) computer network system is required as part of my Work Scope, I am
required prior to such use to undergo a “SingHealth IT Security” orientation programme to
familiarize myself with SGH’s policies concerning IT security. I shall not access the computer
network system without first giving my undertaking to comply with such requirements.
NON-DISCLOSURE & SECURITY AWARENESS UNDERTAKING
FOR EXTERNAL USERS AT SINGAPORE GENERAL HOSPITAL PTE
LTD (SGH) (“Undertaking”)

(a) I acknowledge that I am solely responsible and accountable for the security and use
of any log-in identification, password or smart card assigned to me. I will not at any
point leave a computer terminal unsecured or unattended whilst I am logged into the
SGH or SingHealth computer system.

(b) I acknowledge that my password to log into the SGH or SingHealth computer
network system is equivalent to my signature and that such signature may be used
to sign electronic orders and documents. I agree not to reveal such passwords to
anyone nor allow it to be accessible to anyone. I agree to return the smart card
when I cease my Work Scope.

CONSEQUENCES OF BREACH

I acknowledge that:

(a) In the event of any breach or neglect of my obligations in this Undertaking, SGH may
exercise its right to refuse my access to and/or use of the SGH laboratory facilities.

(b) if I should breach any provision of this Undertaking, SGH may suffer immediate and
irrevocable harm for which damages may not be an adequate remedy. Hence, in
addition to any other remedy that may be available in law, SGH is entitled to
injunctive relief to prevent a breach of this Undertaking.

(c) even after I cease my Work Scope at SGH, I agree that the confidential obligations
herein shall continue to subsist.

Signature of External User :

Name of External User :

Signature of Witness :

Name of Witness :
NON-DISCLOSURE & SECURITY AWARENESS UNDERTAKING
FOR EXTERNAL USERS AT SINGAPORE GENERAL HOSPITAL PTE
LTD (SGH) (“Undertaking”)

*Where External User is under 21 years of age, please obtain a parent’s / legal guardian’s
signature.

I am aware of the External User’s Work Scope at SGH and/or its related companies. I
undertake to ensure due compliance by the External User of this Undertaking.

Signature of External User’s parent /


legal guardian
:

Name of External User’s parent / legal


guardian :

NRIC / Passport No. :

Relationship with External User :

Date :

Signature of Witness :

Name of Witness :

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