HCCI House Call Practicum at Cleveland Clinic, an HCCI Practice Excellence Partner-HCCI Observership Training Agreement

HCCI Observership Training Agreement

Pdf Summary

The document is an agreement and release form for participants in an educational observation activity ("Activity") organized by the Home Centered Care Institute (HCCI). Key points include:<br /><br />1. **Activity Details**: The participant acknowledges the date and location of the Activity, which involves observing healthcare providers at a specified practice, and understands access ends after the Activity period.<br /><br />2. **Observational Nature**: The participant will only observe and not engage in any patient care, contact, or research. Participation does not imply employment or compensation from HCCI, and the participant is not considered an HCCI employee.<br /><br />3. **Conduct and Confidentiality**: The participant agrees to act professionally, maintain confidentiality of any information observed, and not disclose patient details unless involved in the Activity.<br /><br />4. **Termination Rights**: HCCI or the participating facility can terminate the Activity at any time.<br /><br />5. **Medical Expenses**: The participant (or their employer) is responsible for any medical costs incurred due to illness or injury during the Activity.<br /><br />6. **Legal Compliance**: The participant must not be debarred from federal healthcare programs, and HCCI can terminate the agreement if they are.<br /><br />7. **Confidential Information**: The participant agrees to keep all confidential information learned during the Activity private and will return or destroy such information upon request by HCCI.<br /><br />8. **Protected Health Information (PHI)**: The participant must comply with HIPAA regulations and protect PHI observed during the Activity.<br /><br />9. **Intellectual Property Use**: The participant cannot use HCCI's name, logo, or trademarks without written consent.<br /><br />10. **Risk and Liability**: The participant releases and indemnifies HCCI from liability related to airborne pathogens or injuries incurred during activities in patients' homes.<br /><br />11. **Educational Materials Disclaimer**: HCCI’s educational materials are for informational purposes and not a substitute for professional medical advice or treatment.<br /><br />12. **Media Permission**: The participant permits HCCI to use their image and story for promotional purposes and waives rights to inspect or approve media before publication.<br /><br />13. **Indemnification**: The participant agrees to indemnify HCCI against any claims arising from their participation in the Activity, barring HCCI's willful misconduct or negligence.<br /><br />The form concludes with spaces for the participant’s signature and printed name to confirm their agreement to the terms.

Keywords

HCCI

educational observation

confidentiality

HIPAA

indemnification

participant agreement

medical expenses

intellectual property

media permission

legal compliance