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Privacy Policy

In Ontario, your health information is protected by the Personal Health Information Protection Act, 2004 (PHIPA). It sets out the rules that healthcare providers must follow when collecting, using and sharing your health information. In addition, it outlines your rights to confidentiality and access of your information, and allows healthcare providers to share your health information with other providers (such as the hospital or specialists) when is it is used to provide care to you.

Accessing your health information

Most information in your health record is available to you upon request. In many cases there may be a fee which would cover the time required to find the information you’ve requested, the cost of printing or copying the information onto a disk, and postage if applicable. To request access to your health information you may complete this form and bring it to your clinic. You may also ask your clinic to print it for you.

Sharing your health information with others

Lakelands will not share your personal health information with your family members, friends or employer unless you ask us to do so. If you would like us to include family members, such as your spouse or children, in communications about your health then you must let us know. You may ask your provider to add this as a special note in your medical record so everyone on the team will know that we can share your health information with that person anytime until you withdraw the request.

For those who are unable to make their own healthcare decisions, a substitute decision maker may be appointed. For children, this is most often their parent or parents. Once an adolescent is able to make their own informed decisions about medical care, their parent will no longer have access to the health information without the patient’s consent.

To inform our patients about their rights under the Personal Health Information Protection Act, we have displayed this poster, published by the Information Privacy Commissioner, in each of our waiting rooms. It contains information about who can see your personal health information and your rights to privacy. For more detailed information, please read the accompanying brochure.

Lakelands’ physicians take part in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The CPCSSN engages with clinicians, researchers and policy makers to identify how we can improve health care for Canadians. Locally, they are affiliated with Queen’s University at the Centre for Studies in Primary Care. For more information about this important project, please open this poster or look for it in our waiting rooms.

If you have questions, concerns, or requests regarding your personal health information privacy, please contact Lakelands’ Chief Privacy Officer, Jan Powell at 613-336-8888.

Request to Access Private Information

Your Information:(Required)

Substitute Decision-Maker Information*


Preferred method of access to records
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Contact Us


#12357 Highway 41,
Northbrook, Ontario
K0H 2G0

T: 613.336.8888
F: 613.336.2819


31 Central Street,
Denbigh, Ontario
K0H 1L0

T: 613.333.1333
F: 613.333.1263