Privacy Statement

The information collected in this questionnaire will be used to process your referral with Surrey Place's Preschool Speech and Language Program. It may also be used to aggregate statistical analysis and reporting. This system is hosted by an external service provider called Caredove under contract with Surrey Place. Caredove protects all personal health information (PHI). Only authorized Surrey Place staff have access to this system.
The knowledge and consent of the caregiver or individual are required for the collection, use or disclosure of PHI, except where appropriate. Permitted purposes for the collection of PHI include but are not limited to: delivery of direct client care and research.
Please call Surrey Place at 416-925-5141 and connect with our Privacy Officer, Felix Camposano, if you have concerns about data privacy. You can also contact us at any time to withdraw your consent.

Consent to Data Sharing

Surrey Place will share the information in this questionnaire with partner agencies so they can provide the services your child needs. Surrey Place is comprised of 13 partner agencies, but your information will only be shared with the agency or agencies that provide services for your child and family. The agency providing services for your child and family will store your personal information securely in their local clinic database. Please see a complete listing of agencies that deliver Surrey Place HCD services.
If you have any questions about how your personal information will be handled, please call Surrey Place at 416-925-5141 and connect with our Privacy Officer, Felix Camposano. You can also contact us at any time to limit or withdraw your consent.

Consent to Store Personal Health Information

The Preschool Speech and Language Program is part of Ontario’s Healthy Child Development Program which utilizes the Healthy Child Development - Integrated Services for Children Information System (HCD-ISCIS) to store client information. When you access the Preschool Speech and Language Program, your information will be stored in the HCD-ISCIS database. This information includes your contact information; names and birthdates of your family members and any other HCD programs (Infant Hearing, Blind Low Vision Early Intervention) you are accessing. Your information is only accessed by HCD service providers when they provide services to your family and only authorized Surrey Place staff have access to this system.
Your information is protected by privacy legislation, so it is always kept secure. Only the program’s overall statistics are public. If you need more information you can call Surrey Place at 416-925-5141 and connect with our Privacy Officer, Felix Camposano.