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Patient Consent to Email

Computer Store

Read the consent carefully and complete the form below

Uxbridge Health Centre communicates with patients in several different ways.   We can contact you by Email, telephone and by post.  

Email communications has many advantages.  It allows for timely communication of important information in a way that remains clear and easy to access.  It provides a written record that can be referred to as needed.  Emails are cost effective, can be sent at any time of the day or night, and people do not need to be present to receive the email.

Uxbridge Health Centre will use email communication to share information we think may be helpful to you.  This will include appointment reminders, changes to hours of operation, health promotion and some patient care topics.  Your physician may also provide recent test results.  Please note that we have set up safeguards to protect your personal health information from theft, loss, unauthorized access, copying, modification, use, disclosure and disposal. 

Although we recognize the some of our patients would like to email their UHC doctor directly, we are unable to offer this service at this time.  If you would like to communicate with your physician or any member of our team,  we ask that your call our clinic’s main phone number (905) 852-1009.  

While email communication has many advantages, it also comes with a few risks that we want to be sure you are aware of.  Please review the following information carefully – we would like to be sure that you understand and accept these risks before agreeing to communicate with us by email: 

  • Email communication is not considered to be private or secure

  • Your employer may choose to monitor or store email that pass through their system

  • Email is easier to falsify than handwritten or signed hard copies.  In addition, it is impossible to verify the true identity of the sender, or to ensure that only the recipient can read the email once it has been sent.

  • Any email you receive could potentially introduce a virus into a computer system, and potentially damage or disrupt the computer.

  • Emails can be forwarded, intercepted, circulated, stored or even changed without the knowledge or permission of the physician or the patient.

  • An email sender could misaddress an email, resulting in it being sent to an unintended and unknown recipient.

  • Email is indelible.  Even after the sender and recipient have deleted their copies of the email, back-up copies may exist on a computer or in cyberspace.


To mitigate some of these risks, both parties will assume the following responsibilities: 

UHC Responsibilities:  As an organization we are committed to respecting the guidelines set out by Personal Health Information Privacy Act (PHIPA).  All UHC employees and providers have signed and are bound by the clinic’s privacy policy which outlines the absolute confidentiality of patient information.  As such, we take every measure to secure your privacy and do not use your email address for any reason that has not been outlined above.  We will use the minimum necessary amount of personal health information when communicating information to you.

In practice, the clinic requires that the patients verify their demographic information, which includes email addresses, at every visit to confirm accuracy. 

All patient emails are stored on our EMR platform which is securely password-protected.  Communication between all electronic devices used at the clinic and the clinic’s server are encrypted using “Secure Socket Layer” (SSL) protocols.  Firewalls are also used on our systems to prevent unauthorized access to our networks and to stop spam, viruses and other unwanted content before they reach our infrastructure and users. 

Patient Responsibilities:  As the patient, you must ensure that you are providing us with your email address that is private, and not accessed by anyone other than yourself.  You should ensure that your email is protected with encryption software, or if you waive this encryption requirement, understand that this may increase the risk of your privacy being violated.  Should you change your email address, please update the clinic as soon as possible.  If you choose to provide us with your email address, please remember to add no-reply@uxbridgehealth.ca to your “safe sender” list when setting up your junk email options. 

We thank you for the continued privilege of working together towards your health and wellness.

The Uxbridge Health Centre Team

Patient Acknowledgement and Agreement

Thanks for submitting!

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