Privacy Code Information

PRIVACY CODE

The privacy of your personal information is important to the Kucan Chiropractic and Acupuncture Clinic.  We are committed to the collection, storage, use and disclosure of this information in a responsible way.

Personal Information:

Personal information is information about an identifiable individual. Generally, the information we collect is limited to name, home contact information, gender and age. As part of your patient file, we retain your health history, health measurements and examination results, health conditions, assessment results and diagnosis, the health services provided to you or received by you, your prognosis and other opinions formed, compliance with treatment and the reasons for your discharge and discharge recommendations.  We may also maintain records for payment and billing purposes. Only necessary information is collected about you. We only share your information with your consent.  The use, retention and destruction of your personal information complies with and/or exceeds all existing legislation and privacy protection protocols.  These standards are set by our regulatory body, the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO), the College of Chiropractors of Ontario (CCO) and the law.

Clinicians and Staff Members:

Clinicians and staff members who come into contact with your personal information are aware of the sensitive nature of the information you have disclosed to use. They are trained in the appropriate use and protection of your information. These individuals include clinic reception staff and other regulated health professionals, who work in the building.

Disclosure of Personal Information:

Our clinic understands the importance of protecting your personal information. To help you understand how we are doing that, we outline below how our clinic will use and disclose information.

            - to deliver safe and effective patient care

            - to be able to contact you

            - to communicate with your other health care providers, if and when you give us expressed 

permission to do so

            - to complete and submit claims on your behalf to third party payers

- to comply with legal regulatory requirements under the Regulated Health Professions act and the Chinese Medicine Act.

            - to process payments and collect unpaid accounts

By signing the consent section of this form you have agreed that you have given your informed consent to the collection, use and/or disclosure of your personal information for the purposes that are listed.  If a new purpose arises for the use and/or disclosure of your personal information, we will seek your approval in advance.                                        

Contact Processes:

On occasion we may need to contact you regarding scheduling, cancellation or other issues related to your care.  Please ensure that you have made the clinic aware the best ways to contact you and any specific ways (ie. Phone numbers, mail, etc.) that you do not want to be contacted.

I have reviewed the above information that explains how the clinic uses my personal information, and I can review this Privacy Code information on the KCAC website at any time.

I agree that Dr. Graham Kucan, Allison Kucan Hahn and the Kucan Chiropractic and Acupuncture Clinic can collect, use and disclose my personal information as set out above.