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Confidential Information Check

Form to Protect Your Information

Some organizations have clear policies that they will keep your disability information confidential when you share it with them, and others don’t have any. Either way, will they tell you what they have done with it?

This Confidential Information Check form provides a simple way to make it clear that you are sharing private disability information with a company or organization. It asks that they let you know if they are willing to tell you when they share your private information with someone else, creating a record of their either agreeing to let you know when they share your sensitive information or their declining to do so.