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1. I confirm that I am eligible to receive the vaccine at this time and that the information I provide is accurate and not misleading. If my information cannot be verified or is inaccurate, this may result in cancellation of the appointment. 2. I understand that the personal health information being collected is for the purpose of booking a vaccine clinic appointment for me/someone for whom I manage medical appointments. Once collected, this information will be protected and secured. If I have any questions about the collection/use/disclosure/storage/retention of this information, I can call 905-546-2489 (CITY). 3. I consent to receive a confirmation about my appointment via email. 4. I consent to receive a confirmation about my appointment via text message. (Standard message rates may apply) |
