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Child Death Review Case Reporting System Data Use Agreement
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2016-04-05 10:00 AM - Commissioners' Agenda
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Child Death Review Case Reporting System Data Use Agreement
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Last modified
4/7/2018 10:41:46 AM
Creation date
4/7/2018 10:39:05 AM
Metadata
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Template:
Meeting
Date
4/5/2016
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
p
Item
Request to Approve a Child Death Review Case Reporting System Data Use Agreement between the Michigan Public Health Institute and the Kittitas County Public Health Department
Order
16
Placement
Consent Agenda
Row ID
28675
Type
Agreement
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8. I understand that my failure to comply with this Agreement may result in disciplinary <br />action up to and including termination of my employment. I understand that violating <br />applicable laws and regulations may lead to other legal penalties imposed by the judicial <br />system, such as fines and/or imprisonment. <br />9. I understand and accept that signing this agreement is a condition of my employment and <br />those obligations under this Agreement will continue after termination of my <br />employment. <br />Employee Signature: Date: <br />Print Employee Name: <br />Supervisor Signature: Date: <br />Print Supervisor Name: <br />1 1 understand that it is my responsibility to read the Privacy and Confidentiality Policy and any associated <br />policies and understand its terms. If I have any questions concerning information contained in the policy, <br />will bring them to the attention of my supervisor, manager, or Privacy Officer. <br />12 <br />
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