Consent Form

*Students are required to read and complete the consent form prior to seeing a nurse practitioner at Student Health Services.

Privacy and Confidentiality

The information that you provide to Student Health Services (SHS) will inform the support provided to you by staff within the clinic. Your information is stored on the Electronic Medical Record (EMR). The EMR is secure and accessed by the professionals within the SHS. In accordance with professional responsibilities and ethical guidelines, members of the professional team will access your record only if they are involved in your care.

Health providers will explain recommended treatment options and plan of care to students.

The nurse practitioners at SHS are not responsible or liable if a student chooses not to comply with the recommended plan of care.

Saskatchewan's Health Information Protection Act (HIPA) and Local Authority Freedom of Information and Protection of Privacy Act (LA FOIP) describe the rights you have with respect to your personal health information throughout your care at SHS.

You have the right:

to be informed about anticipated uses and disclosures of your information;
to be informed of disclosures without consent;
to access personal health information about yourself;
to request amendments to your record;
to request a review by the Information and Privacy Commissioner or appeal to a court;
to designate another person to make decisions about your health information;
to decide whether to consent to the use and disclosure of your personal information. It should be noted that there are exceptional circumstances in which consent is not required (see Exceptions to Confidentiality below);
to revoke consent to the use or disclosure of your information;
to "mask" or lock your electronic medical record, or portions thereof, and make it inaccessible to care providers other than your own.

Releasing Confidential Information:

For additional information visit www.oipc.sk.ca.

When it is helpful and appropriate to obtain your medical records from previous healthcare provider, you will be required to sign a CONSENT TO RELEASE/REQUEST INFORMATION form.

Exceptions to Confidentiality:

Although rare in their occurrence, there are situations in which it may be necessary to share your information without your consent. These situations are described below:

Where, in the reasonable judgment of the SHS, there is a serious risk to the health and safety of yourself, other members of the university community or the community at large, some of your personal information may be shared with appropriate parties (such as Campus Security, the Police, etc.) in order to ensure your safety or that of others. In such instances, the nature and detail of the information shared would depend on the specific circumstances.
If there is suspected neglect or harm to a child (physical, sexual, verbal and/or emotional), the practitioners within the SHS are legally obligated to share such information with relevant authorities (e.g., Child Protection Services, Crisis Intervention Services) in order to protect the child/children involved. In some instances, release of information about past neglect of or harm to a child may also be required when there is the possibility of current or future risk to another child.
In the event of a court order to release student information, the SHS will be required to comply.
As otherwise permitted or required by law.

Should one of the above situations arise, only the minimum amount of information necessary to resolve the situation would be communicated.

Consent to communication

Telephone and email communication may be used to send you information about appointment bookings or cancellations.

The privacy and security of email and telephone communication cannot be guaranteed in the same way as a private appointment in an exam room. SHS practitioners do NOT provide test results or medical advice over email.

Telephone and email communication will be sent to you within the SHS hours of operation. Clinic staff voicemails and emails are not monitored after hours or on weekends.

Email or telephone communication will be part of your record on the EMR. It is your responsibility to ensure we have your correct uregina.ca email address and phone number.