Consent form

If you seek services at either Counselling Services or Health Services, you will be provided with the following consent form to complete at your first appointment: Exceptions to Consent Form (PDF).

Exceptions to consent requirements

There are certain situations where personal health information can be disclosed without consent. Counselling Services and Health Services may decide or are legally required to use and/or disclose your personal health information without consent in a number of situations including the following:

  • In order to eliminate or reduce a significant risk of serious bodily harm to a person or group of persons or in compelling circumstances affecting the health or safety of an individual;
  • When there is reasonable grounds to suspect that a child (under age 16) or a resident of a long-term care home is or may be in need of protection;
  • For the purpose of a legal proceeding or complying with a court order, or for the purpose of administration and enforcement of various Acts by professional Colleges, Associations, and other regulatory bodies;
  • Reported sexual abuse by a regulated health professional/regulated professional;
  • In order to provide health care to the University of Waterloo campus community, we use a computerized schedule which is accessible to authorized individuals from Counselling Services and Health Services. This system is password protected and is located on a password-protected network. When you access service at either Counselling Services or Health Services your name is entered into this computerized schedule.

Please speak to any staff for any questions that you have.