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13 <br /> Information Flow Assessment Questionnaire <br /> B.ACCESS TO HEALTH INFORMATION <br /> 1.Building <br /> Identify only those persons who have access to your wankgroups physical location and to the health information <br /> maintained by your workgroup.Specify their type of access by populating the Access columns with one of the following <br /> options:Unlimited(U)or Limited(L). <br /> Access <br /> Who Within Bldg. Whin <br /> Ghent Work Areas <br /> Contractors <br /> Administrative <br /> Clinical <br /> Employees <br /> and <br /> Cou !State .. <br /> 7em <br /> General He <br /> Famil !Friends,etc. <br /> Professionals Attome Auditors <br /> Volunteers <br /> Trainin lin-servicelintemshi <br /> Doctors <br /> Nurses <br /> Students <br /> 2.Location <br /> Identify the physical site(s)where health information may be located in your workgroup's area. Speedy with a check made <br /> (✓)by the appropriate options.For each storage mechanism listed you may select more than one site(e.g.,Hallway and <br /> File Room)_ <br /> Spec! ✓ <br /> STORAGE MECHANISM 0 sa atl 8scontl shared Prr a MM Fi <br /> HWMW c=Mn Wont Work Area A. R mm <br /> -Wom Area Ama <br /> Com uter <br /> Co ier <br /> Fax <br /> File/Storage Cabinets <br /> Off-site Home Office,Car,Briefcase <br /> O n SheiveslBookcase <br /> Printer <br /> R cle Container <br /> Shredder <br /> ,J U1Y 2001•version 4 HIPAA 9 <br />