Survey Consent: Cervical Cancer Screening Laboratory Clinician Survey
You are invited to complete this survey because feedback is essential for our continuous quality improvement process. As clients and external participants of the Provincial Health Services Authority (PHSA), you are invited to complete in this survey by the Cervical Cancer Screening Laboratory (CCSL) Medical Director Dr. Diana Ionescu.
If you have any questions about the collection of this personal information, please contact the CCSL Medical Director:
Dr. Diana Ionescu FRCP(C)
Suite 900 686 West Broadway, Vancouver, BC, V5Z 1G1
604-877-6000 ext 2117
dionescu@bccancer.bc.ca
You may also contact the CCSL Medical Director if you wish to withdraw your consent.
The results of this survey will be collected anonymously. You do not have to participate. There will be no penalties if you do not want to participate. It should take less than 5 minutes to complete the survey.
Your personal information is protected by our privacy law in BC (called the Freedom of Information and Protection of Privacy Act (FIPPA)). For this survey, your identifiable information is collected under section 26 (e ) of FIPPA. We will only use your information for the purposes listed on this form. In this survey you will be asked to share the following information for use by PHSA:
1. Personal views/opinions expressed in this survey.
We do not intend to identify you. For open ended responses, please do not share information that might identify you or someone else. When survey results are reported, presented, or published we will not include any data that could identify you.
Only the study team and the technical support team at CCSL will access your information. The study team will run the survey and analyze the results. Survey data will be stored in the PHSA's secured network electronically for 2 years. You will not be provided with survey results. For questions about the collection of your information, please contact the PHSA Privacy Office by emailing privacy@phsa.ca or calling 1.855.229.9800.
Consent
I have read and understand this form. I voluntarily consent to PHSA collecting, using, and disclosing the information I provide as a survey participant. Your consent is implied when you complete this survey.