Universal Personal Information Notice and Consent

  • The Notice and Consent is intended to inform you how The Can-Am Indian Friendship Centre of Windsor (“the Friendship Centre/Delivery Site”) will collect, use and disclose your personal information.
  • In order to provide programmes and services safely and efficiently, the Friendship Centre/Delivery Site requires certain pieces of personal information from you. The federal Personal Information Protection and Electronic Documents Act and equivalent provincial legislation requires that your consent be obtained prior to the collection and use of that information.
  • Your personal information may be collected formally, in writing, and informally, by the Friendship Centre/Delivery Site staff. This may include age, gender, marital status, income, education, disability, employment history, and any other information which the Friendship Centre/Delivery Site requires in order to deliver programmes and services safely and efficiently. Your personal information may be collected from time to time. Consent for the use of that personal information may be referred where its uses are obvious and it has been voluntarily provided.
  • Only necessary information will be collected about you. The Friendship Centre/Delivery Site will collect, use, and disclose information about you for the following purposes: - To enable the Friendship Centre/Delivery Site to contact you; - To ensure you are eligible for programmes and services; - To develop plans of care and practice case management of you file; - To ensure you are physically and mentally able to participate in programmes and services offered by the Friendship Centre/Delivery Site; - To provide specific information into a data collection system, specific to the programmes(s) in which you participate; and, - For anonymous statistical analysis of programmes and services.
  • The storage, retention and destruction of your personal information complies with the Friendship Centre/Delivery Site’s maintenance policy, applicable legislation and privacy protection protocols, to ensure its confidentiality. All staff at the Friendship Centre/Delivery Site are sworn to an Oath of Confidentiality.
  • Your information will only be shared upon your written consent, except the following: - For programmes reporting requirements, some personal information is sent to the Ontario Federation of Indian Friendship Centres, which may be transmitted in electronic form; - For studies, research, or reports on issues specific to the urban Aboriginal peoples, with any of your identifiable information removed; and, - For the purposes of eliminating or reducing significant risk of serious bodily harm to any individual or group of peoples.
  • Your consent may be withdrawn at any time by notice to the Friendship Centre/Delivery Site or its Executive Director.
  • You may access your own personal information, or request corrections, through a written request to the Friendship Centre/Delivery Site or its Executive Director.
  • Your consent may be withdrawn at any time by notice to This consent form will serve for all Friendship Centre/Delivery Site programmes you access, with on programmes designated as your primary provider and your original consent kept in that programmes file.
  • COMPLETE THIS PART IF THE CLIENT IS CAPABLE OF CONSENT.
  • Date Format: MM slash DD slash YYYY
  • COMPLETE THIS PART IF CLIENT IS UNDER 18 YEARS OF AGE, IS INCAPABLE OF CONSENT, OR IF AN INDIVIDUAL HAS BEEN ASSIGNED TO ACT ON HIS OR HER BEHALF.
  • Date Format: MM slash DD slash YYYY