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NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

12-20-2010

Subchapter:

1

Forms

Issuance:

8.80

DCF Form 8-80, DCF Confidentiality Agreement (For Non-Employees)

 

 

Click here to view or print DCF Form 8-80, DCF Confidentiality Agreement (For Non-Employees).

 

PURPOSE AND USE

 

The form is used to:

 

·         Inform individuals who work for the Department of Children and Families, but who are not employees of DCF, of the importance and legal implications of maintaining client confidentiality; and

 

·         Provide a mechanism to acknowledge the responsibility to keep CP&P and other DCF client information confidential.

 

Examples of those who must sign this form include:

 

·         Students,

 

·         Interns,

 

·         Volunteers,

 

·         Foreign language and hearing impaired interpreters,

 

·         Deputy Attorneys General who represent CP&P,

 

·         Nurses working for a contract provider to serve CP&P/DCF,

 

·         Non-CP&P paralegals who are provided CP&P office space,

 

·         Consultants who have access to CP&P or DCF client records,

 

·         Contractors who have access to CP&P or DCF client records,

 

·         Employees from other State agencies who have access to CP&P or DCF client records.

 

Employees of the Administrative Office of the Courts who have access to client information contained in NJ SPIRIT sign an Individual Agreement between: The New Jersey Administrative Office of the Courts and the New Jersey Department of Children and Families, Division of Child Protection and Permanency, in lieu of the DCF Form 8-80.

 

APPLICABLE STATUTES AND ADMINISTRATIVE ORDERS

 

CP&P has a responsibility to keep confidential information about its clients and former clients as described by New Jersey statutes, N.J.S.A. 9:6-8.10a, and New Jersey rules, N.J.A.C. 10:133G. Non-employees who perform work for DCF are required to maintain this confidentiality as guided by the provisions of these statutes and rules. See CP&P-IX-G-1-100 and CP&P-IX-G-1-200 , which outlines policy about the disclosure of case information.

 

INSTRUCTIONS FOR COMPLETING THE FORM

 

DCF Form 8-80 is prepared in triplicate by the DCF representative.

 

The DCF representative and the non-employee sign and date three copies of the agreement in the designated spaces provided. Type or print the names of the DCF representative and non-employee in the spaces provided.

 

DISTRIBUTION

 

Original

-

DCF non-employee record or office file

 

Copy

-

Non-employee

 

Copy

-

Organization or college sponsoring the non-employee