Consent To Disclose Health Information

THIRD PARTY REQUESTS FOR HEALTH INFORMATION

The Grande Prairie PCN has taken measures to ensure it meets its privacy and information security obligations under the Health Information Act and follows guidance provided by the Office of Information and Privacy Officer Commissioner with respect to electronic communications. The PCN encourages the same of all other organizations. As such, the Grande Prairie PCN expects that all emailed third party requests for patient health information be encrypted and sent to admin@grandeprairiepcn.com. If you are not able to encrypt your request please fax the document to 587-259-9774. You can download a printable version of the Consent To Disclose Health Information form HERE, or complete the online fillable form HERE.

Consent To Disclose Health Information (online fillable form)

Consent To Disclose Health Information (printable)