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Email Consent

Share your email with us!

You may receive:

  • appointment reminders
  • important clinic information
  • specialist appointment information
  • bloodwork & diagnotic testing requistions
  • test results and follow-up instructions from your doctor
  • records you request
  • newsletters about clinic programs, health information & news

Please review the following email policy and submit consent below.

Patient Consent for Email Communication

Your care provider can communicate with you using email but you will need to understand the risks of using email:

  • The security of email messages is not guaranteed.  Messages sent to, or from, your care provider may be seen by others using the internet.  Email is easy to forge, may be accidently forwarded, and may exist indefinitely.  For this reason, it is recommended that you do not use email to discuss information you think is sensitive.  If you decide to use email, please tell your care provider if there are certain types of information that you do not want to discuss by email.  
  • Do not use email in an emergency because email can be delayed or your care provider may not be able to read it soon enough.  

Please note:

  • Your provider will talk to you about which types of conversations you are both comfortable having over email (e.g. scheduling appointments).  Your care provider may not feel comfortable discussing some topics by email (e.g. to give test results) and will tell you if another way will be used. 
  • Your care provider may make decisions about your care based on information you provide in email. 
  • If an email has information that is important to your clinical care it will be copied or summarized into your medical records -much like a phone conversation. 
  • Email may be forwarded or read by other UHN staff who need the information to provide you with care.  Your care provider will tell you if another person will read or reply to your email on their behalf.  

This consent form lets us know when we may use email to communicate with you or others who are outside the hospital.  

If at anytime you decide that you no longer want to communicate by email, please tell your care provider as soon as possible.  Your care provider will do the same. 

Please note: it may take 2-3 business days to update your file

Email SPAM Filters: we have heard from many patients that our emails do get caught in SPAM filters, please check your junk mail for emails from us -and make us a safe sender. 

We encourage you to sign up for UHN MyPortal.  

Your Details


Name:
 
Date of Birth:
Parent/Guardian:
OHIP #:
Email:
Confirm email:
 
Phone Number:
 
Message:
 
By completing the above form and submitting to the Toronto Western Family Health Team you have read the above information about using email communication and accept the risks of using email communication.