A patient confidentiality contract is produced between the doctor and the patient party wherein the doctor is bounded to keep the medical & biological information of the patient confidential.

Sample Patient Confidentiality Contract:

Contract number: 34/ PC

Date: February 14th, 2011

This Patient Confidentiality Contract is made & registered between Mr. Hennery Williams, Address: house no: 34, Sky High Society, Salt Lake City, New York, America, hereinafter called as the patient party.


Dr. Anderson Smith, Address: Heart care Clinic, Spencer Road, New York, America, hereinafter called as the doctor party.

Whereas, the patient party is willing to get cured for the AIDS disease and is ready to hire the services of the doctor party and the doctor party is agreed to the confidentiality conditions for the same.

This contract is effective from February 15th, 2011 and is ending on February 15th, 2012.

Term & Conditions:

Duties & Obligations:

The doctor party will use the provided medical reports of the patient party for examining the health risk factors and will use the information with the consent of the patient party.

Confidentiality Term:

The doctor party is not allowed to discuss the medial history and the diagnosis reports of the patient party to the third party in any case. This information will be kept hidden during the treatment and any kind of outflow of such data will be treated as a legal offence.


If any kind of violation is recorded to the above mentioned clauses and the breach of the confidentiality clause is done, this contract will be dissolved immediately.

Validation of the Patient Confidentiality Contract:

Patient Party:                                                                         Doctor Party:

Hennery Williams                                                  Anderson Smith

Leave a Reply

Your email address will not be published. Required fields are marked *