Annual Notice
Annual Notice Regarding Education Records
This form is to clarify Novant Health Clinical Pastoral Education Programs’ processes for release of educational records.
Novant Health’s CPE Programs guarantee its CPE Students the right to inspect and review education records to seek to amend them, and to specify control over release of record information.
Before release information, CPE Students must have received the Annual Notice Regarding Education Records Form from Novant Health’s CPE Programs. Each CPE Student has the right to review their specific directory information and opt out of releasing record information via written notice to the lead Certified Educator. The written objection will be kept with and released with the record.
Common directory information includes the following: name, address, email, telephone, date of birth, religious/spiritual/value system affiliation, previous education, and photograph. All other information is released only with the student’s written, signed, and dated consent specifying which records are being disclosed, to whom, and for what limited purpose. Current CPE Students can restrict directory information and/or record access at ay time during attendance. Restrictions must be honored even after the student’s departure. Former CPE Students cannot initiate new restrictions after departure.
CPE Student Records include the following per Novant Health’s CPE Program & ACPE’s expectations:
10 Year Records:
- Application Face Sheet
- Completed Use of Clinical Materials Consent Form
- ACPE Certified Educator’s End of Unit Evaluation
- CPE Student’s Response to the Certified Educator’s End of Unit Evaluation if submitted
- The CPE Student’s End of Unit Final Self-Evaluation
Indefinite Records:
- Application Face Sheet
- Completed Use of Clinical Materials Consent Form
Supervisory Notes: The ACPE Certified Educator may keep process notes on a CPE Student. These process notes are for the exclusive use of the writer and are not considered a part of the CPE Student’s record. They must be kept separately from the CPE Student’s record.
Health records (mental and physical) must be kept in locked, limited access files, separate from other student records. Their use and release is subject to ADA and HIPAA. Certain safety and employment records are also subject to other federal regulations and state laws, and are to be kept separately.
Material written by CPE Students, such as verbatims and case histories, that contain information about other persons, including other CPE Students, will either be destroyed or, if they are part of the CPE Student’s record, will have the identifiable information about everyone other than the CPE Student redacted. When peers are referenced in a CPE Student’s evaluation, only initials should be used.
CPE Students are allowed to review their record within 45 days of a written request. Record inspection cannot be denied based on the CPE Student’s inability to come to the site or outstanding financial obligations. In the latter case, a CPE program can note a copy sent, “not available for official use.” When a CPE Student record contains identifiers of another CPE Student, those must be redacted.
Digital and Electronic Student Records:
- CPE program must maintain CPE Student records, either digitally or on paper, in compliance with ACPE Standards and the CPE program’s policy for CPE Student Records management.
- Digital and electronic CPE Student records have the same storage requirements as paper records.
- Digital records must have at least one backup separate from the original hardware location. Backups should be dated and updated at least monthly or in accordance with institutional guidelines.
Violations of Annual Notice protocols may be reported to the Chair of the Accreditation Commission at:
ACPE, Inc
1 Concourse Parkway
Suite 800
Atlanta, GA 30328
Or via email: accreditation@acpe.edu