ESBD_480458_1772567900176_Exhibit G - HHS Information Security Acceptable Use Agreement.pdf

This is an Information Security Acceptable Use Agreement form required by the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) for individuals accessing HHS information resources. The agreement mandates that users read and acknowledge compliance with the Information Security Acceptable Use Policy before gaining access to HHS systems. The form requires completion of acknowledgement fields including signature, printed name, work email, work phone, and the date the agreement is signed. Users must identify their role within the HHS ecosystem by selecting one of six categories: HHSC employee, DSHS employee, employee of another agency, contractor, intern or volunteer, or other designations such as advisory council members or private provider employees, with specification of the relevant department, division, or employer name required.

The agreement includes an optional HHS Employee ID field for applicable individuals. The form references an Information Security Acceptable Use Policy available through a SharePoint link, which users must review in its entirety before signing. No pricing terms, set-asides, incumbents, funding requirements, or contract award information are applicable to this document, as it functions as a prerequisite compliance and acknowledgement form rather than a procurement solicitation or contract award notice.