Evaluation of ARRA Comparative Effectiveness Research Dissemination Contract Efforts

Battelle Assurance of Confidentiality of Survey Data

Battelle Memorial Institute is firmly committed to the principle that confidentiality of individual data obtained through surveys must and shall be protected. This principle holds true whether or not any specific guarantee of confidentiality was given at time of interview, or whether or not there are specific contractual obligations to the client. When guarantees have been given or contractual obligations regarding confidentiality have been entered into, they may impose additional requirements, which are to be strictly adhered to by all staff working on the project.

Procedures for Maintaining Confidentiality

• You shall sign this assurance of confidentiality. This assurance may be supplemented by another comparable assurance for a particular project.
• You shall keep completely confidential the names of respondents and/or study subjects, all information or opinions collected in the course of conducting work, and any information about respondents and/or study subjects otherwise learned, directly or indirectly, during work. You shall follow applicable practices and policies and exercise reasonable precaution to prevent survey data or names of study participants from being disclosed.
• Upon encountering a respondent or information pertaining to a respondent that you know personally, you shall immediately cease the activity and contact your supervisor for further instructions, unless specifically instructed otherwise for a particular project.

Pledge of Confidentiality

• I hereby certify that I have carefully read and will comply fully with the above procedures on confidentiality. I will keep confidential all information arising from surveys concerning individual respondents and/or study subjects to which I gain access. I will not discuss, disclose, disseminate or provide access to survey data and identifiers, except as specifically authorized by Battelle for a particular contract. I will devote my best efforts to ensure that there is compliance with the required procedures by any personnel whom I may supervise. I understand that violation of this pledge is sufficient grounds for disciplinary action, including immediate dismissal. I also understand that violation of the privacy rights of individuals through unauthorized discussion, disclosure, dissemination, or access may make me subject to criminal or civil penalties. I give my personal pledge that I shall abide by this assurance of confidentiality.
• In addition to any and all confidentiality obligations contained in my employment agreement with Battelle, I shall not, during or after my employment with Battelle, for any reason whatsoever, unless I receive express written permission from a Battelle officer, reproduce, copy, disclose or divulge to anyone, directly or indirectly, any information or knowledge relating to the past, present or future business operation or internal structure of any project conducted by Battelle.
• I acknowledge and agree that all files, records, manuals, memoranda, notebooks, documents, correspondence, and all other information or records and similar items relating to the business of Battelle, whether prepared by me or otherwise coming into my possession, are, and shall remain, the exclusive property of Battelle, and shall be promptly delivered to Battelle promptly upon demand by a Battelle officer.

Signature: I have read and understand and agree to abide by the provisions contained in this memorandum, and have received a copy of this memorandum which is hereby acknowledged. I understand that a copy, signed by me, will be placed in my employment file.

Acknowledged: ___________________________________ Date: ________________

Onboarding Facilitator, please return the completed form to the HRIS Office, Rm. 13-3-022L, 505 King Ave, Columbus, OH 43201.

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