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I understand that UofC Staff Wellness Occupational Health Services are designed to help protect myself and the community from risks associated with my occupational exposures. I authorize my personal individually identifying health information (which may infer diagnostic, treatment and care information, registration information, and health services provider information) to be collected in accordance with the Health Information and Freedom of Information and Privacy Acts to the Occupational Health Providers of Staff Wellness for the following purpose(s): Assessment of my occupational exposure risks and recommendation of suitable precautions. I understand that the information will be collected, used and disclosed in accordance with applicable laws and the University’s Privacy Policy. I understand that I make revoke my consent at any time, by providing a signed, written statement to that effect.
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