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Date:
Hospital Name:
Medicare Provider
ID Number:
Hospital Address:
City:
State:
User First and
Last Name:
Title:
COMPUTER
SYSTEM USER AGREEMENT and RULES OF BEHAVIOR:
System-specific
Rules of Behavior (RoB) must be created for each HRSA Major Application
and General Support System as part of the System Security Plan.
It is the responsibility of each user to know and understand the
Rules of Behavior and other security policies. Being unaware of
a policy does not remove culpability if a policy is violated. At
a minimum, all users should comply with the following rules:
- I am required
to comply with HRSA Information System Security Policies regarding
the protection of HRSA information systems from misuse, abuse,
loss, or unauthorized access or modification.
- I have completed
the required HRSA computer security awareness web training on
____________. The training took me approximately ______________.
________ Initials
- I must create
and use password(s) consisting of at least eight (8) characters
that cannot be easily guessed and that do not contain a word found
in any language. My password must contain letters, numbers,
and at least one special character (e.g. @, !, $, %). I
am required to change my password every 60 days or at the interval
prescribed for the system. I must not reuse old passwords.
I understand that HRSA reserves the right to change my password
or terminate my access at any time.
- I must protect
my passwords and application user-ID’s (this will be provided
to you by the CHGME Database Manager once training is complete).
Should I suspect a compromise of my password or application user
codes, I must change my password immediately and report the suspected
compromise to my supervisor and the CHGME Database Manager (DM)
immediately. I will not enter my password or application user
code(s) in a file or record maintained in any automated system
for the purpose of affecting an "auto login" feature
for my convenience, unless the feature has been approved for use
by the HRSA Information Security Program Manager. I must not share
my user-ID and passwords and I must not write down my password
or application user codes.
- I must logoff
any time that I leave my terminal unattended. The system will
automatically log the user off after thirty (30) minutes.
I must use a password protected screen saver at any time that
I leave my terminal unattended for time periods longer than fifteen
(15) minutes. Users must not leave sensitive information in an
unsecured location.
- I am required
to notify the system database manager for my system immediately
when there is a change in my employment status and/or when my
access to the system is no longer required.
- I will access
only those applications for which the system administrator has
authorized access. I will use the government website only for
approved purposes.
- I am prohibited
from using information acquired from access via a Federal web
based system for personal gain.
- I will not
attempt to override technical or management controls (e.g. carrying
sensitive data home on a floppy disk without prior approval).
- I will ensure
that my anti-virus software is up to date.
- I will report
all incidents immediately to the CHGME Regional Manager in Rockville
who will inform the DM immediately. The DM will then notify the
supervisor and call the Help Desk at 301-496-4357.
- I understand
that my actions while on a HRSA system may be monitored.
- I understand
that if I must use Personally Identifiable Information (PII) (for
example: social security number, bank records, health records
and so on...) then to only use it to the extent necessary to perform
my job duties if sensitive or PII data is to be stored or transmitted
it must be encrypted using a FIPS 140-2 compliant utility (ex:
SecureZip). WinZip may be used if the data is NOT sensitive
or does not contain PII.
- Users are
prohibited from using licensed HRSA software for personal use.
- HRSA policy
allows outside entities to access to the HRSA LAN/WAN from a remote
location as long as the user has been approved to do so. Users
are responsible for updating virus protection software on their
systems.
- If a user
violates any of these Rules of Behavior and/or HRSA policies,
they may be subject to disciplinary action at the discretion of
HRSA management. These actions, depending on the severity of the
violation, may include a verbal or written warning, removal of
system access, reassignment to other duties, or termination.
I acknowledge
and certify, as an Authorized Individual ("User") requiring
access to the HRSA information systems that I have read, understand,
and agree to adhere to the HRSA IT Rules of Behavior as listed above.
| User
Certification
I certify
that I have read, understand, and agree to adhere to the Computer
System Users Agreement, HRSA Policies, and the HRSA Guide
for Use of Government Websites and Information Systems |
| Printed
Name |
Signature |
Hospital
Name |
| Address |
Phone
Number |
Date |
| Certifying
Official (from HRSA 99-3 - CHGME Application) Certification
I certify
that I have read, understand, and agree to adhere to the Computer
System Users Agreement, HRSA Policies, and the HRSA Guide
for Use of Government Office Equipment and Information Systems
|
| Printed
Name |
Signature |
Hospital
Name |
| Address |
Phone
Number |
Date |
|