Street Address *
Phone Number *
Organization and Profession
Name of Organization *
Educator EMS/First Responder Licensed Nurse Licensed Pharmacist Licensed Physcian Pharmacy Tech Social Services Student Other
Preferred Target Audience (select all that apply) *
Preschool K-5th 6th-8th 9th-12th College Caregivers/Adults Other
Main reason for taking this course *
Work Requirement Personal Interest Other
<18 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99
Information Protection Agreement
The purpose of this agreement is to protect the Georgia Poison Center's (GPC) Poison Prevention Training Program (PPTP) electronic information from accidental or intentional disclosure or modification. This agreement is intended to serve as a general information protection overview, and may be supplemented by other specific policies required by law such as the Health Insurance Portability and Accountability Act (HIPAA). This agreement applies to GPC's trained PPTP Educators and all others granted use of electronic information resources, and upholds their responsibility for the protection and appropriate use of GPC information. Within the context of this policy, information referes to all information that is electronically processed, stored, used or transmitted. Information resources include, but are not limited to: software, computer applications and e-mail. Compliance with this policy is mandatory. Each user must understand his/her role and responsibilities regarding information security issues, and protecting GPC's information. Any non-compliance with this or any other security policy that results in the compromise of GPC information integrity may result in possible prosecution under applicable legislation. I agree to maintain and protect GPC's information from any unauthorized alterations (add/change/delete). Furthermore, I agree to protect and maintain GPC's information that is electronically processed, stored, used or transmitted to or by me from any intentional and unintentional violcation.
The information contained in this training is designed to be informational and educational. Under no circumstances is this training to replace the expert advice of a qualified health care professional. In the event of a poison emergency, contact the Georgia Poison Center immediately. The Georgia Poison Center, its employees and affiliates assume no responsibility in the usage of the information provided in this training.