ACPE Non-disclosure Agreement for Information From Student Records *

I understand that as a member of the ACPE involved in processing complaints of ethics code violations, I may have access to information from confidential student records. I will not retain copies of those records or information, nor will I disclose or use any information I might obtain from them in any process other than the one in which I am currently authorized to participate.

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Signature of ACPE member and Date

  • Form is to be signed by anyone viewing or using student records in the context of an ethics review if student records will be viewed.