Confidentiality Agreement for Drug Reps

April 4, 2008

I, ________________, am a representative of __________________ (pharmaceutical firm name).

I understand that _____________, M.D. has a legal and ethical responsibility to maintain patient privacy, including obligations to protect the confidentiality of its patients’ Individually Identifiable Information (IIHI), as the term is defined in 45 C.F.R. Part 164 (the “Patient Information”), and to safeguard the privacy of Protected Health Information.  In addition, I understand that during the course of my affiliation with _____________, M.D. I may see or hear other Confidential Information, including without limitation business accounts, financial information, clinical protocols developed by Dr. _____________ (“Confidential Information”).  I understand that the Confidential Information is owned exclusively by Dr. _____________, used in the operation of its business, and is secret, confidential, and proprietary to Dr. ____________.

I understand and acknowledge that any use or disclosure of IIHI, PHI, or other Confidential Information in violation of this Agreement will cause Dr. ____________ irreparable harm, the amount of which may be difficult to ascertain, and therefore agree that Dr. ___________ shall have the right to apply to a court of competent jurisdiction for specific performance and/or an order restraining and enjoining any such further use, disclosure, or breach and for such other relief as Dr. __________ shall deem appropriate.  Such right of Dr. ____________ is to be in addition to the remedies otherwise available to Dr. ____________ at law or in equity.  I expressly waive the defense that a remedy in damages will be adequate and further waive any requirement in an action for specific performance or injunction for the posting of a bond Dr. ___________. By signing this document I understand and agree that any Confidential Information learned incidentally through my affiliation with Dr. __________ will not be revealed to any other individual, company, or entity.

Signed_________________________

Date_______________________

 

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