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CONFIDENTIALITY AGREEMENT
Potential Purchaser (“Purchaser”)
Consani Associates Ltd. (“Broker”) permits Purchaser to have access to Broker’s clients
(“Seller’s”) patient files, tax returns,
appointment books, accounting/office records, personnel files, financial data, operating
data, and other information necessary
to understand Seller’s practice (“Seller’s Confidential Information”) so that Purchaser
may conduct a due diligence investigation.
Visits to the Seller’s office are made by pre-arranged appointment only.
Purchaser may permit Seller, at Purchaser’s option, to have access to Purchaser’s tax
returns and other financial information
(“Purchaser’s Confidential Information”), to permit Seller to conduct a due diligence
investigation with respect to Purchaser’s credit.
Nothing in this agreement requires either party to furnish anyinformation. However the
parties expressly agree that any Seller’s
Confidential Information or Purchaser’s Confidential Information (together “Confidential
Information”) which is furnished or
otherwise obtained is confidential. Buyer agrees to share theinformation with
professional advisors and spouse only, and agrees
to respect the fact that Seller’s desire that the fact that their practice is for sale
–be kept confidential from the Seller’s
staff and patients and the dental community at large.
The parties will hold Confidential Information confidential, and will not disclose it to
any person other than their attorneys,
brokers, and accountants. Careless or neglectful handling of this information or
material could result in liability for all parties involved.
I agree to maintain the privacy protections and restrict the use and disclosure of all
patient information (verbal, written or electronic)
obtained from this dental officeonly for the purposes of serving this dental office.
I understand that I may not sell, barter, give away or reveal any patient information for
personal or business gain or any form of
marketing or fund raising.
I will contract with any subcontractors towhom I pass this information to hold all
patient information confidential and further disclose
it only for the purpose for which it was disclosed to them in the service of this dental
office.
I will keep current with the industry standards for security, implement and maintain
appropriate safeguards to protect this information
and document all disclosures of this information with name, address and reason
disclosed.
I will contact this dental office if I become aware of any situation in which that
confidentiality of any patient information is breached
within 24 hours of discovery, as well as take corrective action to mitigate the damages.
I will make all records concerning patient information and disclosure available to the
dental office and to the US Department of Health
and Human Service.
I understand that if there is a breach in my privacy obligations, my services may be
terminated.
I agree to return or destroy all patient information and keep no copies after the
termination of my affiliation with thisdental office.
I understand that the above restrictions are for the duration of my affiliation with this
office and survive termination of my affiliation
with this office.