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Faculty of Health Sciences

Michael G. DeGroote National Pain Centre

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Freedom of Information & Protection of Privacy Act

The information gathered on this form is collected under the authority of The McMaster University Act, 1976. Personal information is gathered, used and disclosed in accordance with the McMaster University privacy policy and applicable legislation, including the Freedom of Information and Protection of Privacy Act (Ontario) (‘FIPPA’). The information gathered will be used by the Michael G. DeGroote National Pain Centre for the purposes of assisting with inquiries and collecting feedback, for statistical purposes and other related purposes. Personal information provided on this form will not be used for any unrelated purpose without prior consent. This information is protected and is being collected pursuant to sections 39(2) and 42 of FIPPA. Questions regarding the use or collection of this personal information should be directed to the Michael G. DeGroote National Pain Centre, MDCL-2102. For complete details on the McMaster University Policy on the Collection of Personal Information, please visit the University Secretariat website.