Privacy and Confidentiality Form

Please check the box below:*
- I provide consent for the BC Patient Safety & Quality Council to share my responses to an engagement invitation with the health care partner leading the engagement. I also consent to my name and email address being shared with other selected volunteers participating in the same opportunity.
Please choose your region in BC:*
- Fraser Valley & Lower Mainland Region
- Interior Region
- Northern Region
- Vancouver Island Region
I understand compliance with this Agreement is a condition of participating in the mentorship program with the Patient Voices Network and that failure to comply may result in a discontinuation of my involvement and follow-up by BCPSQC.
To sign the Privacy, Safety & Confidentiality Agreement, please fill out your full name below:*
Email*
Date:*
MM slash DD slash YYYY

From Our Community

Shannon Griffin

Leader, Patient and Family Centred Care in Fraser Health

Recently, a PVN Patient Advisor asked healthcare partners, “What are we learning from patients, families, and others thus far during this pandemic?”. This is an excellent question and one to ask ourselves daily.