Form 1 Public Statement

Our Privacy Commitment to You

We are committed to protecting your privacy and ensuring the confidentiality of your personal Health information. The types of personal health information we collect may include your name, date of birth, health history, and records of care provided to you. We collect, use and disclose personal health information for the flowing purposes:

We will conduct, use and disclose only as much personal health information as is needed to achieve these purposes. You can withhold or withdraw your consent to the collection, use or disclosure of your personal health information by contacting us (details below).

Access to Health Records

You have the right to seek access to your health records that we keep and to ask us to correct a record if you believe it is inaccurate information or incomplete. Please contact us for more information.

Questions or Concerns?

If you have questions or concerns or want to make a complaint about our privacy practices, Please Contact: Tracy Ragusa

Also, you have the right to take your complaint to the Privacy Commissioner of Ontario or at the address below if you have concerns about our privacy practices or how your personal health information has been handled:

Information and Privacy Commissioner/ Ontario

2 Bloor Street East, Suite 1400, Toronto, Ontario M4W 1A8

Telephone: Toronto Area (416/local 905): (416) 326-3333

TDD/TTY:(416) 325-7539

Fax:(416) 325-9195