New Confidentiality Undertaking Form

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New Confidentiality Undertaking Form

A new, single Confidentiality Undertaking form is now available for all pharmacy staff, including registrants, who have access to personal health information.

Starting December 1, any new pharmacy staff who have access to personal health information will need to complete the form before they start working at a pharmacy.  

Current pharmacy staff who have access to personal health information will need to complete the new form by March 1, 2021. 

Confidentiality Undertaking Form 


(View PDF)

All registrants must ensure personal information is protected at all times in accordance with federal and provincial privacy legislation as well as the Health Professions Act bylaws.  

In addition, section 18(2)(w) of the College’s PODSA Bylaws requires anyone who will access the in-pharmacy computer system to sign an undertaking in a form approved by the registrar to maintain the confidentiality of patient personal health information.

Previously, pharmacy staff, including registrants, were required to complete one of five confidentiality undertaking forms, depending on their role at the pharmacy. 

The new, single Confidentiality Undertaking Form replaces those forms and has been broadened to include the collection, usage and disclosure of any personal health information, not just information contained within PharmaNet. 

This new form must be signed by all individuals who may have access to personal information at the pharmacy including but not limited to:

  • Pharmacists 
  • Pharmacy Technicians 
  • Pharmacy Assistants/Support Persons 
  • Pharmacy Owners

Pharmacy managers must ensure that individuals who currently have access to personal information, sign this new form before March 1, 2021, and that all new pharmacy staff and new pharmacy owners, who have access to personal information on and after December 1, 2020, sign this new form instead of the old forms.  

Pharmacy managers must keep the signed copies at the pharmacy for 3 years after employment, or any contract for services, has ended in accordance with section 18(2)(x) of the PODSA Bylaws. The signed copies do not need to be sent to the College; however, they must be made available to the College when requested. 

All registrants should be aware that this new Confidentiality Undertaking form is not the same as the Terms of Access agreement for PRIME enrollment from the Ministry of Health.  

For questions about the new Confidentiality Undertaking Form please contact the College at: 

[email protected]

Nov 30, 2020