Privacy Training

HIPAA Checklist for: Visitors and Observers

The HIPAA Steering Committee has developed visitor and observer guidelines to ensure a consistent approach to confidentiality, health, safety and compliance at UCSF. The guidelines provide a decision process for handling visitors who come into contact with our patients and their protected health information. They were originally distributed to the campus and Medical Center in December 2005.

Click below to download: (requires Adobe® Acrobat®, see download information below)

• "UCSF Guidelines for Visitors & Education with Direct Interaction with Patients (Confidentiality/Health/Safety/Compliance)" — Summary matrix/decision process.
• "UCSF Guidelines for Faculty & Staff with Direct Interaction with Patients (Confidentiality/Health/Safety/Compliance)" — Summary matrix/decision process.
• "UCSF Confidentiality Statement for Clinical Education Observer" — To be signed by visitors to clinical areas who may encounter patients and/or PHI.
• "Consent For Presence of Observer During Medical Procedure and Nursing Care" — A three-part form to be signed by the patient, observer, and attending physician/ RN when an observer will be present during a medical procedure (form# 500-0095A/B).
• "UCSF Volunteer Confidentiality Statement for Minors" — To be signed by the parent/guardian of minor observers who may be informal visitors or participants in a formal volunteer program.
• Sample Language for an Attendee Sign-in Sheet — To be used for any educational program involving non-UCSF attendees in which PHI may be shared.

Additional Information

• Health Screening guidance (Including Health Assessment, TB Screening, Immunizations). For more information contact UCSF Occupational Health program.
• How to obtain an ID card
• How to obtain Fingerprinting Services