HIPAA ACKNOWLEDGEMENT & EMPLOYEE CONFIDENTIALITY

I, _KAKARLA THIRUPATHI___, an employee of Infinite Computer Solutions, acknowledge the sensitivity,

confidentiality and HIPAA rules when handling Patient Health Information (PHI) that I may receive or have access
to in the course of providing support to Health care project.

Maintenance and Use of PHI by Employee:

• I agree that, I will only use and disclose PHI created or received by me during the term of my employment,
for the purposes of carrying out the provisions of the above said project
• I hereby agree to maintain the security and privacy of Patient Health related Information as defined under
HIPAA guidelines and other laws as applicable.
• I also understand that I am not allowed to print/ copy/ divulge in person or over any other communication
channel any PHI during or after my employment with Infinite.

Violations include but are not limited to:

• Accessing information that is not within the scope of the assigned job
• Disclosing/ altering/ using patient’s personal information without proper authorization
• Sharing of login credentials assigned to me or using another person’s login credentials for accessing any
kind of records
• Leaving a secured application unattended while logged on
• Attempting to access a secured application without proper authorization

Reporting of Unauthorized disclosure of PHI

If I notice or get information of any unauthorized or inadvertent use or disclosure of PHI, I agree to immediately
report it to the Compliance officer (CISO)

Termination of Employment upon Breach of Agreement.

Any breach of this agreement will result in disciplinary action and could possibly lead to termination of
employment.

MY SIGNATURE BELOW ATTESTS to the fact that I have read, understand, and agree to be bound to all of the above
terms.

KAKARLA THIRUPATHI

Employee Name and Employee ID

Employee Signature

Date :26/04/2021