Attachment 4 - Privacy Agreement

Attachment 4 - Privacy Agreement.docx

[NCEZID] Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Attachment 4 - Privacy Agreement

OMB: 0920-1071

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Project Staff Agreement of Privacy

Ensuring the privacy of all reports, records and files containing client names and/or identifying information is critically important to the Centers for Disease Control and Prevention (CDC) and Banyan Communications.


I, _______________________, agree to provide recruitment/screening, research/analysis, and/or advisory support services for the benefit of Banyan Communications in conjunction with the Banyan Communications/CDC project, Harmful Algal Blooms Communication Evaluation.


Further, I


____ hereby accept all duties and responsibilities of performing specified support tasks and will do so personally in accordance with the training and guidelines set out by Banyan Communications/CDC;


____ will not engage the services of another person or organization for the purpose of performing specified support tasks for me without prior written approval from Banyan Communications /CDC;


____ promise to perform only the support tasks specified by Banyan Communications and will not conduct any auxiliary services without the approval of Banyan Communications/CDC;


____ agree to treat as private and proprietary to Banyan Communications/CDC any and all project materials, and documentation provided or accessed while employed on this project;


____ am aware that any information collected is very important, and therefore agree that all work completed will be of high quality and performed in compliance with project guidelines;


____ agree to keep all client-related project documents and records, as well as any identifying information, closed and locked in accordance with the principles set forth by Banyan Communications/CDC;


____ agree to never discuss sensitive office issues or records outside of the office setting, nor confirm or deny any specific person’s participation in the project;


____ agree to act professionally in a manner that will obtain the respect and confidence of all individuals participating in this project from whom information will be collected and not betray their confidence by divulging information obtained to anyone other than authorized representatives of Banyan Communications/CDC;


____ agree to report any known or suspected breaches of confidentiality to Banyan Communications/CDC; and


____ understand that my obligations to maintain the confidence and privacy of the project and participants’ personal information under this agreement will survive the termination of any assignment and my affiliation with Banyan Communications/CDC.



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Highly Sensitive/Any User (No encryption)

Highly Sensitive/Any User (No encryption)

Highly Sensitive/Any User (No encryption)


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJacobi, Amy (CDC/NCEZID/DFWED/WDPB)
File Modified0000-00-00
File Created2024-08-01

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