Renaissance Ranch Ogden Family Confidentiality Agreement

  • I have a full understanding that I am being permitted to attend family groups at Renaissance Ranch during group hours. In this circumstance, I understand I will see and hear things that are discussed in the utmost confidence of the patients attending this program through Renaissance Ranch. I am therefore agreeing that I am bound by Utah stat law 42- CFR part 8 to not discuss whom I see or what I hear outside the clinic. I agree to keep all patient information confidential.
    (Notice: This communication may contain protected health information, the release of which is restricted by federal law. Any information about a client or clients has been disclosed to you from records protected by federal confidentiality rules governing federally-assisted drug or alcohol abuse programs (42 CFR part 2) and the Heath Insurance Portability and Accountability Act of 1996 (HIPAA). The federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person whom it pertains or as otherwise permitted by 42 CFR part 2, and HIPAA. A general authorization is NOT sufficient for this purpose.)
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