Please review the notice of collection and consent of information below to continue.
COLLECTION OF PERSONAL AND PERSONAL HEALTH INFORMATION
The personal information provided is collected under the authority of section 5 of the Health Protection and Promotion Act. The information will be used for the purposes of contacting you to determine your interest and eligibility in a Healthy Babies Healthy Children (HBHC) program or service, and to inform HBHC program delivery, evaluation, and administration. Information will be collected, used, and disclosed in accordance with the Personal Health Information Protection Act, 2004, S.O. 2004, c.3.
CONSENT TO THE COLLECTION OF INFORMATION
I consent to the Medical Officer of Health for the Regional Municipality of Durham electronically collecting personal and personal health information for the following purposes:
- To follow up with me either by phone or email to determine my interest in a HBHC program or service;
- To determine whether I am eligible for a particular HBHC program or service;
- To create an electronic health record to document our interactions with you;
- To provide me with information on HBHC programs and services that I am eligible for.
WITHDRAWING CONSENT
You may withdraw your consent to the collection, use and/or disclosure of your information at anytime. Questions about this collection of information should be addressed to the Manager, Health Information, Privacy and Security at 605 Rossland Road E., P.O. Box 730, Whitby, ON, L1N 0B2.
By selecting the “I confirm” button I acknowledge that I have read, understood and accept how information will be collected, used and disclosed by Durham Region Health Department.
