Date of entry into force: 1 June 2023
We collect personal information from our patients in order to provide them with dental services. This information may include, but is not limited to :
We use your personal information to provide you with dental care:
We may also use your information to improve our dental services and to comply with legal and regulatory requirements.
We only collect personal information that is necessary for the purposes identified in this policy. Personal information is not used or disclosed for purposes other than those for which it was collected, except with the consent of the individual or as required by law. Personal information is retained only as long as necessary for the fulfillment of those purposes.
Personal information will be collected through a combination of online and paper forms, face-to-face interviews and communication with Dr. Sylvain Chamberland staff.
We do not share your personal information with third parties except as necessary for the provision of dental services, such as with dental laboratories for the creation of dental appliances, or with insurance companies for the processing of claims.
Dr. Sylvain Chamberland will not give, sell or rent my personal information to third parties. We will only share information with your consent or where required by law.
Personal information is generally stored or processed in facilities located in Quebec. Some of this data may be processed by third parties outside Quebec. If this is the case, Dr. Sylvain Chamberland will take reasonable steps to ensure the protection of your data with the third parties in question.
We take reasonable steps to protect your personal information from unauthorised access, use or disclosure. Despite this, no security mechanism can guarantee perfect protection and there will always be some residual risk.
Our office uses secure filing systems, effective identity and access management and physical safeguards to protect your information, all in compliance with the laws and regulations in force.
You have the right to access, modify or delete your personal information. You may withdraw your consent to the collection and use of your personal information at any time. However, this could prevent Dr. Sylvain Chamberland, for example, from providing you with adequate dental services.
You have all the rights in accordance with legal and regulatory requirements.
If you wish to exercise these rights, please contact the Dr. Sylvain Chamberland office at 418 847-1115.
If we make significant changes to the policy, we will inform you by publishing a notice or by posting a new version of the policy on our website.
Date of last update: 15 august 2023
I, the undersigned, SelectMissMrs.Mr
for hereby consents to the collection, use and disclosure of my personal information by
Dr. Sylvain Chamberland, Orthodontist to provide me with dental services.
I acknowledge that I have received information on how my personal information will be collected, used, shared, stored and protected.
I have read and understood the above information and voluntarily consent to the collection and use of my personal information as described.
First and last name
for: (Patient’s first and last name)
Patient file subject: (Patient’s first and last name)
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First and last name
(Patient’s first and last name)