DECLARATION OF CONFIDENTIALITY OF PATIENT INFORMATION
I……………………………………………………………………………………..working in the clinical biochemistry laboratory, LSSTH, Bhavnagar as laboratory technician/ laboratory assistant fully understand the meaning of confidentiality of patient information as defined by NABL.
I hereby declare that I will not disclose patient information to any individual unless the patient concerned has consented or the individual is a health professional involved in the care of the patient.
I further declare that I will not discuss patient information with
•	One patient about another patient.
•	Relative and friends of the patient.
•	Visitors of any setting.
•	News media.
•	Fellow workers.
I am also aware that violation of the above declaration will lead to the instant dismissal of my service from laboratory services, LSSTH, Bhavnagar.
I acknowledge receipt of a copy of this document


Date:									Signature
Place: Bhavnagar
									Name of the employee
As head of the Department, I hereby certify that this employee has been provided with necessary instruction for the above.