Data Collector Confidentiality Agreement

Att A3. Data Collector Confi Agree 111518.docx

Customer Surveys Generic Clearance for the National Center for Health Statistics

Data Collector Confidentiality Agreement

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Attachment A3. Data Collector Confidentiality Agreement Form


Data Collector Confidentiality Agreement

2M RESEARCH SERVICES DATA COLLECTOR CODE OF CONDUCT

AND

ASSURANCE OF CONFIDENTIALITY


2M Research Services is committed to the collection of high-quality independent and unbiased data. This Code of Conduct and Assurance of Confidentiality defines the principles that are at the foundation of our data collection. By following these principles, 2M Research Services assures clients, researchers, educators, business leaders, and policy makers that they can have confidence in the data that have been collected.


The basic principles guiding data collection are:


I. Ethics

  • All respondents, who may be either individuals or institutions that participate in our studies, are to be provided with the information about the basic elements of a study as set forth in survey materials.

  • Respondents are to be treated with respect and their concerns are to be addressed promptly, openly, and courteously.

  • Data Collectors are to maintain high standards of personal conduct and perform their job in a manner which will not harm, humiliate, or mislead respondents.

  • Data Collectors have an obligation to submit time information that accurately reflects the work performed.


II. Work Style

  • Data Collectors are to follow the study protocol and procedures as specified in the study manual, at training, and in post-training memos.

  • Data Collectors are to perform work that conforms to the quality requirements for the study.

  • Data Collectors are to perform their work as effectively as possible and in such a way that meets the goals set for the study.

  • Data Collectors are to accept responsibility for the quality of the data they collect and the work they complete.

  • Data Collectors are to demonstrate commitment, initiative, consistency, and organization in their approach to the work.

  • Data Collectors are to display a professional attitude during the conduct of their work.

  • Data Collectors are to communicate professionally and effectively with clients, respondents, and other employees.

  • Data Collectors are to work effectively with the project team.

  • If at any time Data Collectors have questions or concerns, they should immediately contact their supervisor.

III. Confidentiality
A. Policy on Confidentiality of Survey Data

2M Research Services is firmly committed to the principle that the privacy of respondents and the confidentiality of individual data obtained through the completion of 2M Research Services surveys must be protected. This principle holds whether or not any specific guarantee of confidentiality was given at the time of data collection, and 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 adhered to strictly.


B. Protecting the Privacy and Rights of Survey Participants

Successful survey research depends upon the cooperation of respondents. Data Collectors are expected to gain cooperation using the methods described at training sessions or by their supervisor. Data Collectors are also expected to respect the privacy of respondents and must not engage in any selling or promotion of products or services or in any other activity unrelated to the survey.


C. Procedures for Maintaining Confidentiality

  1. All 2M Research Services employees and Data Collectors shall sign this Confidentiality Agreement. This agreement may be superseded by another agreement for a particular project.


  1. Data Collectors shall keep completely confidential the names and addresses of respondents, all information or opinions collected in the course of the interviews, and any information learned incidentally about individual respondents, responding organizations, or the places and organization where respondents work and live. Data Collectors shall exercise care to prevent access by others to survey data in their possession.


  1. Unless specifically instructed otherwise for a particular project, an employee or Data Collector, upon encountering a respondent or information pertaining to a respondent that s/he knows personally, shall immediately terminate the activity and contact his/her supervisor for instructions.



D. Requirement and penalties related to Confidential Information Protection and Statistical Efficiency Act of 2002 (CIPSEA) (PL-107-347)

All 2M Research Services employees and Data Collectors will not disclose or release responses in identifiable form without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act of 2002 (CIPSEA, Title 5 of Public Law 107-347). In accordance with CIPSEA all 2M Research Services employees and Data Collectors have taken an oath and are subject to a jail term of up to five years, a fine of up to $250,0000, or both if he or she willfully discloses ANY identifiable information in any manner to a person or agency not entitled to receive it.

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Print Name

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Signature

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Date

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2M Research Services Representative Printed Name

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2M Research Services Representative Signature

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAmy Wieczorek, MPH
File Modified0000-00-00
File Created2021-01-20

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