DeedPoll

For StudentsandStaffattendingPlacements (non-health)

This is an important document.

Students and Staff attending placements must read and sign this Deed Poll.

Students and Staff must maintain a signed copy of their Deed Poll and provide it to any Placement Organisation and Flinders University on request.

This Deed Poll is given for the benefit of Flinders University and a Placement Organisation.

Flinders University and Placement Organisations place high importance on maintaining confidentiality and protectingprivacy of Placement Organisation clients, students and other third parties they interact with. Students and Staff on placements may haveaccess to confidential and personal information and need to be familiar with and understand requirements to maintain confidentially and also their responsibilities generally when on placement.

Confidential informationisany information that is by its nature confidential or is designated by a Placement Organisation as confidential (or Students or Staffought to know is confidential) and includes:

(a)information concerning the processes and policies, commercial operations, financial arrangements or affairs of a Placement Organisation or Flinders University;

(b)any agreement relating to a placement;

(c)information relating to clients, patients, students or recipients of services from a Placement Organisation;

(d)personal information, i.e. information or an opinion (including in a database), whether true or not, and whether recorded in material form or not, about an individual whose identity is apparent or can reasonably be ascertained, from the information or opinion; and

(e)all other documents, information, equipment and data that is not publically available and which is made available by a Placement Organisation to Students or Staff in connection with a placement.

By signing this Deed Poll, you acknowledge and agree to comply with the obligations in it. This Deed Poll and the obligations set out in it apply to you in respect of all placements you attend after signing the Deed Poll.

You should note that somePlacement Organisations will have additional obligations that you must agree to comply with before participating in a placement with that organisation.

Bysigning this DeedPoll, Iacknowledge and agreethat:

1.While participating in a placement I will comply with all:

(a)Placement Organisation and Flinders University requirements relating to privacy, confidentiality and occupational, health, safety and welfare;

(b)conditions or restrictions communicated to me by the Placement Organisation or Flinders Universityabout the use of Placement Organisation materials and, when my placement ends, return all Placement Organisation material to the Placement Organisation;

(c)reasonable instructions and directions of the Placement Organisation and Flinders University including safety instructions, rules or procedures; and

(d)policies, procedures and regulations of Flinders University and the Placement Organisation notified to me from time to time including academic and disciplinary policies of Flinders University.

2.I will undergo all health, medical, criminal history and other checks that a Placement Organisation requires prior to participating in a placement with that Placement Organisation.

3.If I am participating, or scheduled to participate, in a placement, I willpromptly notifythe Placement Organisation and Flinders University:

(a)of any medical or other condition thatwhich is pre-existing or develops during the placement that may affect my ability to participate in the placement; and

(b)if I am unable to participate in the placement because of illness or any other reason.

4.Except as expressly authorised by the Placement Organisation or Flinders University or required by law, I will not disclose to any third party any confidential information that I obtain or access during the placement.

5.If I am a Student, the Placement Organisation will own all right and title to, and intellectual property in, all client and business records created by me at the direction or control of that Placement Organisation during the placement.

6.If I am a Student and:

(a)I create any material (including but not limited to original works, documents, computer software, and data stored by any means) (Student Material) that is intendedbythe Placement Organisation to be usedforthe benefit ofthe Placement Organisation and/orits clients;or

(b)asa resultof an activityortaskwhich has been solelycarried outforthepurposes ofaplacement,Ihave adapted,used,modified orincorporateda substantialamountofmaterialownedbyorlicensed to the Placement Organisation intothe Student Material,

I will negotiate in good faith with the Placement Organisation to enter into a separate agreement dealing with the ownership and licensing of intellectual property rightsin the Student Material.

Signed as a Deed Poll by the Student / Staff member named below:

______
Signature of Student / Staff member
______
Print Name of Student / Staff member
______
Date of signing / ______
Signature of witness
______
Print name of witness

Flinders University Student/Staff Deed Poll – Placements – version 1, Nov 2016 Page 1 of 2