Privacy and confidentiality

Steps to complete and submit a confidentiality form:

1. The student accesses the Student confidentiality form.
2. The student downloads the form and opens it using Adobe.
3. The student fills out the form electronically, providing their signature, and then clicks on the SUBMIT button located at the bottom of the page.
4. After clicking SUBMIT, the student is prompted to save their completed form on their computer.
5. Once saved, an email will automatically open with the student’s default email account (such as Outlook or Gmail) and attaches the saved form. If the student does not have a default email account on their computer, the student can open their email account, attach the signed form and send to StudentConfidentiality@fraserhealth.ca.
6. The student presses the SEND button to send the email.
7. A confirmation email from Fraser Health is received by the student, confirming the submission.
8. To provide proof of submission, the student forwards the confirmation email to the post secondary institution.

If the student is unable to use Adobe for providing an electronic signature, please follow these steps:

1. Save a copy of the form to the student's desktop.
2. Print out the form and complete it manually.
3. Scan the filled-out document.
4. Attach the scanned document to an email.
5. Instruct the student to send the attached form to studentconfidentiality@fraserhealth.ca.
6. This emailed form will serve as the "original" document.

Have the student mail in the original document to:

Fraser Health
Attention: Student Practice
#400 – 13450 102 Ave
Surrey, BC V3T 0H1

The form provides an option for a parent or guardian to electronically sign it. The student can sign the form electronically, save it, and then email it to their parent or guardian. The parent or guardian can sign, save and send it back to the student. The student can review the form and click the submit button, which will automatically generate an email to be sent to us.

Alternatively, the parent or guardian can sign the form first and send it to the student, who can then sign and submit it. Please note that the form cannot be submitted without a signature from either the student or the instructor who is acknowledging the content.

Yes, it's important to note that each health care organization has its own form to ensure privacy and confidentiality. If a student is doing their placement at Fraser Health, they will need to fill out the form specific to Fraser Health.

No. The form only needs to be filled out one time and covers the duration of their program.