The following video addresses the sensitivities, confidentiality, and responsibilities surrounding HIPAA laws and patient privacy.  After watching the video, a series of questions will be asked in order to assess your understanding of the content.

AFC Employee Training 2017 - HIPAA (Part 1)



The following training video explains our responsibilities related to HIPAA and patient privacy laws.  A short quiz will be required after the video.  Successful passing of the quiz will meet your initial or annual HIPAA employee training requirement for 2017. 

HIPAA Compliance Officer

Advanced Fertility Care/AZ Advanced Surgery Center Officer Information

HIPAA Security Officer:   Danielle Kaczmarek

The HIPAA Security Officer shall be notified immediately when:

  • Upon discovery of any unauthorized disclosure
  • Patient Requests to Amend Records
  • A potential violation/breach is witnessed

HIPAA 2017

Protected health information (PHI) can ONLY be given out after obtaining written authorization.


Staff must be trained:

  • Annually
  • Initially
  • Once is enough, and it doesn’t matter when
  • A and B

If you suspect someone is violating the facility’s privacy policy, you should:

  • Say nothing. It is none of your business
  • Watch the individual involved until you have gathered solid evidence against him or her
  • Report your suspicions to your HIPAA Officer for further follow-up

TRUE or FALSE:  A nurse violated HIPAA by leaving a message on a patient's home phone even though the patient had asked only to be contacted at work.

  • Type your statement here...

Signed authorizations for release of information are considered invalid if there is no expiration date.

  • Type your statement here...

Disclosure of individually identifiable health information to an outside healthcare provider (physician, hospital, nursing home) even for treatment purposes requires a written authorization by the patient.

  • Type your statement here...

The spouse of your patient approaches you in the hallway to inquire more about his wife's condition. Earlier this morning, the patient stated that she did not want information shared with anyone in her family. You should:

  • Give the husband the minimum necessary information about his wife.
  • Tell him that you are unable to share information about her health care.
  • Enter the patient’s room and ask her if it is okay.
  • Tell her husband, but make him promise to keep the information private.

Match the HIPAA Term to Correct Definition

  • What does HIPAA stand for?
    Hospital Insurance Portability and Accountability Act
  • What are the three phases of HIPAA?
    Electronic Data Interchange, Privacy, and Security
  • Storage of paper information with PHI
    Should be in a locked cabinet
  • Notice of Privacy Practices
    Must be given to patient and must sign an acknowledgment of receipt
  • Notice of Privacy Practices is
    the patients rights regarding confidential information.

Employee Non-Disclosure / Confidentiality Agreement - HIPAA (Part 2)

Employee Non-Disclosure / Confidentiality Agreement

Employee Non-Disclosure / Confidentiality 

I have viewed and understand Advanced Fertility Care's policies regarding the privacy of individually identifiable health information (or protected health information (“PHI”)), pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  In addition, I acknowledge that I have received training concerning the use, disclosure, storage and destruction of PHI as required by HIPAA, and that I understand the material set forth in the HIPAA Training Module provided by Advanced Fertility Care.  I further understand that, through my affiliation with Advanced Fertility Care, I will be exposed to privileged, intimate and personal information in addition PHI (such information and PHI shall collectively be referred to as “PHI” herein).

I understand that HIPAA requires many of Advanced Fertility Care's clients to have detailed policies and procedures in place that dictate how employees can use patient information, when they can disclose it, and how they should dispose of it.  In consideration of my employment with and/or compensation from Advanced Fertility Care, I hereby agree that I will not at any time—either during or after my employment or affiliation with (a) Advanced Fertility Care or (b) its clients—use, access or disclose PHI in any manner to any person or entity, internally or externally, except as is required and permitted in the course of my duties and responsibilities with Advanced Fertility Care or its clients, and as permitted under their privacy policies and procedures as adopted and amended from time to time or as permitted under HIPAA.  I understand that this prohibition includes, but is not limited to, disclosing any information about the identity of the patients with whom I work or any information about them, including their medical and other personal information, to family, friends, other patients, other clients, or co-workers, unless such person is lawfully authorized to receive such information. I agree to document uses and disclosure of PHI as required by the clients and/or HIPAA and to return or destroy all PHI associated with the clients upon the termination of my services. I agree that I immediately will report to Advanced Fertility Care and to the client with which I am placed any impermissible PHI use or disclosure.

I understand that my person access code, user ID, access key, password and similar access information will be kept confidential at all times.  I understand that I will not remove from Advanced Fertility Care any devices or media unless instructed or authorized to do so.  I agree to return all means of access to PHI upon termination of my employment with Advanced Fertility Care.

I understand and acknowledge my responsibility to apply the policies and procedures of Advanced Fertility Care. I understand that unauthorized use or disclosure of PHI will result in disciplinary action, up to and including the termination of employment or affiliation with Advanced Fertility Care and its clients and could result in the imposition of civil and criminal penalties under applicable laws, as well as professional disciplinary action.

I understand that my obligations will survive the termination of my employment or end of my affiliation with Advanced Fertility Care and its clients, regardless of the reason for such termination. I understand that my obligations extend to any PHI that I may acquire during the course of my employment or affiliation with Advanced Fertility Care or its clients, whether in oral, written or electronic form and regardless of the manner in which access was obtained. I understand that I should contact an administrative officer of Advanced Fertility Care if I have any questions, comments or concerns about the training I received or my obligations under this agreement.

I have read the Employee Non-Disclosure / Confidentiality Agreement and:

  • I understand and accept the conditions.
  • I do NOT accept the conditions.