JVS Toronto – North

INFORMED CLIENT CONSENT TO COLLECT, USE AND DISCLOSE PERSONAL INFORMATION

Privacy of personal information is an important principle to JVS Toronto. We are committed to collecting, using and disclosing personal information responsibly and only to the extent necessary for the service provision.

Personal information is collected directly from you, or the person acting on your behalf. Information collected may include your name, date of birth, address, and employment history. JVS Toronto ensures that only people involved in your service provision see your information and we will not disclose that information to third parties without your consent, unless we are legally required to do so. JVS Toronto has a number of security safeguards in place to protect your information.

By signing this form, I acknowledge that the following topics were discussed with me:

  • Services to be provided.
  • Potential outcomes for these services and available alternatives.
  • JVS Toronto practices for protecting personal information.
  • Information that will be collected and how it will be used and disclosed.
  • Limits of confidentiality.
  • Right to withdraw consent at any time.
  • File retention policy.
  • Sharing of information within service team and for quality assurance.

I, the under-signed, had an opportunity to have my questions answered regarding these practices and I understand the purposes for which my personal information is being collected, used and disclosed.

I hereby authorize the collection, use, storage and disclosure of my personal information by JVS Toronto to facilitate the provision of services in compliance with JVS Toronto’s Policy Policies.

Canadian Anti-Spam Legislation Consent

JVS Toronto requests your consent to send electronic messages about the agency (that is not part of your service/program provision), such as notices, announcements, events, fundraising activities, and other similar offers. For more information on Canada’s anti-spam laws, visit: http://fightspam.gc.ca/eic/site/030.nsf/eng/00303.html. For JVS Toronto’s privacy policies, visit www.jvstoronto.org/privacy-policy/.

Please provide your consent below. You can change your mind and withdraw your consent by contacting your JVS Toronto representative. *
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