Mount Royal Surgical

Privacy Policy

Collection, Use and Disclosure of Personal Information

What personal information do we collect?
Identification and contact information (name, address, date of birth, emergency contact, etc.)
Billing information (provincial plan)
Health information (symptoms, diagnosis, medical history, test results, reports and treatment, record of
allergies, prescriptions, etc.)

Limits on collection
We collect only the information that is required to provide care, administrate the care that is provided,
and communicate with you. We do not collect any other information, or allow information to be used for
other purposes, without the express (i.e. verbal or written) consent – except where authorized to do so
by law.

When and to whom do we disclose personal information?
Implied consent for provision of care: By virtue of seeking care from us, your consent is implied (i.e.
assumed) for your information to be used by this office to provide you with care, and to share with other
providers involved in your care. In addition, we obtain written consent for various procedures.

Disclosure to other health care providers:
Relevant health information is shared with other providers involved in your care, including (but not
limited to) other physicians and specialists, pharmacists, and lab technicians.

Disclosures authorized by law:
There are limited situations where we are legally required to disclose your personal information without
your consent. These situations include (but are not limited to) billing provincial health plans, reporting
infectious disease, or by court order.

Disclosures to all other parties:
Your expressed consent is required before we will disclose your information to third parties for any
purpose other than to provide you with care or unless we are authorized to do so by law. Examples of
disclosures to other parties requiring your express consent include (but are not limited to) third-party
medical examinations.

Can you withdraw consent?
You can withdraw your consent to have your information shared with other health care providers or
other parties at any time, except where the disclosure is authorized by law. However, please discuss this
with your healthcare provider first. Your healthcare provider’s philosophy is to do the right thing, for the
right patient, at the right time and for the right reason.


Patient Rights

How do you access the personal information held by this office?
You have the right to access your record in a timely manner. If you request a copy of your record, one will
be provided to you at a reasonable cost. If you wish to view the original record, one of our staff must be
present to maintain the integrity of the record, and a reasonable fee may be charged for this access.
Patient requests for access to the medical record can be made in writing to

Limitations on access
In extremely limited circumstances you may be denied access to your records, but only if providing
access would create a significant risk to you or to another person.

What if you feel your record is not accurate?
We make every effort to ensure that all of your information is recorded accurately. If any inaccuracy is
identified, you can request that a note be made to reflect this on your file.
Office Safeguards

How secure is your information?
Safeguards are in place to protect the security of your information. These safeguards include a
combination of physical, technological, and administrative security measures that are appropriate to the
sensitivity of the information. These safeguards are aimed at protecting personal information against loss
or theft, as well as unauthorized access, disclosures, copying, use or modification.

What is our communications policy?
We protect information regardless of the format. Specific procedures are in place for communicating by
phone, e-mail, fax, and post/courier.

How long do we keep information?
We retain patient records as required by law and professional regulations.

How do we dispose of information when it is no longer required?
When information is no longer required, it is destroyed in a secure manner, according to set procedures
that govern the storage and destruction of personal information.

Complaints Process
There is a formal written compliant process in place. Please request this document from If you believe that this office has not replied to your access request or has
not handled your personal information in a reasonable manner, please address your concerns first with
the OR Manager.