Confidentiality Agreement - Chai Lifeline Canada

Chai Lifeline Canada Branch?*
Name*
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Email*
As a Chai Lifeline volunteer/staff member, I understand that in the course of my contacts with families served by Chai Lifeline, I might learn privileged and confidential information that is of a highly personal nature. Examples of such information might be, but are not limited to: medical condition and treatment, finances, living arrangements, employment, identifying information and relationship among family members. I understand that all such information must be treated as confidential. I agree not to disclose any information I learn about patients/clients and their family members to anyone, except a Chai Lifeline staff member. I will also make certain that any disclosures are made in a private setting in which no one can overhear any information that is conveyed. I understand unauthorized disclosures are considered grounds for immediate termination of volunteer status. I understand and am willing to honour the time commitment required for my volunteer assignment and accept direction from Chai Lifeline staff designated. I agree to fully review policies and procedures outlined in the Chai Lifeline volunteer manual when issued to me.*
- I agree
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Toronto

300A Wilson Ave.
Toronto, Ontario, M3H 1S8
Phone: 647.430.5933
Fax: 416.628.1597

Montreal

4900 Jean Talon Ouest, #220 Montreal, Quebec H4P 1W9
Phone: 514.667.7041

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At Chai Lifeline Canada we are passionately devoted to alleviating the burden of those facing medical challenge. From the moment of diagnosis, through the arduous months and years, in good times and bad, Canadian families have discovered that Chai Lifeline Canada is a friend for life.

Chai Lifeline Canada. Fighting Illness with Love.

Chai Lifeline Canada is a registered Canadian charity
Reg. No. 85656 5536 RR0001

Chai Lifeline Canada is a member of the OCGA

©2020 Chai Lifeline Canada. All rights reserved. Design & Development by LeverageIT

©2023 Chai Lifeline Canada. All rights reserved. Design & Development by LeverageIT. Chai Lifeline Canada is a registered Canadian charity. Reg. No. 85656 5536 RR0001. Chai Lifeline Canada is a member of the OCGA

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