All patients of the Student Wellness Centre must fill and submit this form once per year.
Please contact the Student Wellness Centre if any questions or concerns regarding the content of the Agreement.
COMPLETE THE STUDENT WELLNESS CENTRE PATIENT AGREEMENT form
GOVERNING LAW AND JURISDICTION AGREEMENT
This agreement (“Agreement”) is entered into by and between the patient/client and the Student Wellness Centre, McMaster University (Collectively, the “Parties”). The Parties hereby agree that all aspects of the relationship between the patient/client and the Student Wellness Centre, McMaster University, as well as her/his/their agents, delegates, employees, and any physicians and other independent healthcare practitioners providing medical or other healthcare and treatment to the patient/client, or in association with The Student Wellness Centre, McMaster University, including without limitation any medical or other healthcare and treatment provided to the patient/client, and the resolution of any and all disputes arising from or in connection with that relationship, including any disputes arising under or in connection with this Agreement, shall be governed by and construed in accordance with the laws of the province or territory of Ontario (other than conflict of laws rules) and the laws of Canada applicable therein. The Parties hereby acknowledge that the medical or other healthcare and treatment received by the patient/client from the Student Wellness Centre, McMaster University will be provided in the Province of Ontario, and that the Courts of Ontario shall have exclusive jurisdiction to hear any complaint, demand, claim, proceeding or cause of action, whatsoever arising from or in connection with that medical or other healthcare and treatment, or from any other aspect of the relationship between the patient/client and the Student Wellness Centre, McMaster University.
PRIVACY AND CONFIDENTIALITY
The Student Wellness Centre provides care for registered students at McMaster University. We believe that the best counselling and health care are provided in an atmosphere that respects privacy and guarantees confidentiality. Any information you share with your health care providers or other Student Wellness Centre staff will be held in the strictest of confidence. Ontario has a law that protects your personal health information, the Personal Health Information Protection Act (PHIPA). The Student Wellness Centre follows this legislation, and staff are bound as a condition of employment, and by law and ethics, to safeguard your privacy and the confidentiality of your personal information. We will only collect information that may be necessary for your care, keep accurate and up-to-date records, and retain and destroy records in accordance with the law. You have the right to see and to obtain copies of your records. Please see our brochure and Privacy Statement for more details.
We will share general information or impressions with other Student Wellness Centre health care providers involved in your care and disclose information to third parties only with your signed consent or where legally required. No information will be released by us to anyone without your signed consent except in accordance with provincial legislation. You should be aware of the following situations in which your personal information may be disclosed to persons outside the Student Wellness Centre without your consent:
Otherwise, family, friends, University officials, faculty, and other third parties will not have access to information from the Student Wellness Centre about you, or about whether or not you have used our services.
USE OF ARTIFICIAL INTELLIGENCE IN DOCUMENTATION
Our clinic may use a transcription tool that utilizes Artificial Intelligence (AI) tool to create a draft of your medical note during your visit. This helps your provider focus on you, improves documentation accuracy, and supports timely care. All personal health information is protected under Ontario’s Personal Health Information Protection Act (PHIPA). Your provider reviews and approves all notes before they become part of your chart. You may decline the use of AI at any time without affecting your care. For more information, please discuss with your healthcare provider.
ELIGIBILITY AND DISCHARGE FROM SWC SERVICES
Who is eligible for services?
Access to Services
You will have access to services offered at the Student Wellness Centre (SWC) throughout the year (12 months). You must present your MacCard and proof of valid health insurance coverage when booking or checking in for an appointment.
Eligibility and Termination of Care
Your therapeutic relationships with SWC healthcare providers—including physicians, counsellors, and others—will end if you are no longer registered as a student at McMaster University, or if you are enrolled in fewer than 18 units and no longer paying supplemental fees. Students on medical leave will be transitioned to appropriate community healthcare providers or counsellors.
Exception for Students on Leave
Students on leave may continue accessing services until their supplemental fees expire or until they are successfully connected with a community healthcare provider. For example, a student who paid full supplemental fees in September may continue to access services until August 31 of the same academic year, even if they are on a leave of absence. Once supplemental fees have expired, students are no longer eligible to access SWC services. It is the student’s responsibility to secure a new healthcare provider or counsellor. SWC staff can provide resources to assist with this transition. For more information on eligibility please refer to the SWC eligibility policy on our website.
VIRTUAL CARE
The Student Wellness Centre may provide virtual patient/client care services (i.e. telephone consultation, videoconferencing) at the discretion of the care provider if you have an existing relationship with the care provider and an Ontario health card. SWC cannot provide virtual care to students with out of province health cards.
The Student Wellness Centre will only provide virtual care services to patients/clients who are physically present in Ontario at the time of their appointment. Patients/clients who are not physically located in Ontario will use alternate means of care, such as consulting a local care provider or accessing virtual care services that permit out-of-province use.
Virtual care is not a substitute for in-person communication or examinations for all health matters, or for attending the emergency department or urgent care centre when necessary (including for any emergency care that may be required). In certain circumstances, your care provider may determine that virtual care is no longer appropriate and suggest alternative means of care (e.g. an in person appointment, assessment at an emergency department or urgent care center, call 911). Similar to in-person encounters, digital communications will be documented in your health record.
The Student Wellness Centre will use reasonable means to protect the privacy of your personal health information. It is imperative that the virtual session takes place in a quiet, private space that is free of distractions, with reliable internet and/or telephone service. No one will record the session without permission from all participants. Risks involved in using virtual care technologies include the potential for privacy breaches resulting from unauthorized physical or electronic eavesdropping, hacking and software exploits, technical failures, and configuration errors. You accept the risk of loss of privacy or confidential health information associated with virtual care and nonetheless agree to its use. You also agree that any regulated healthcare professional and/or McMaster University shall not be liable for any type of damage or liability arising from or associated with loss of confidentiality due to digital communication. Since McMaster University does not operate or control any service on the internet, you understand that McMaster University cannot and does not guarantee that use of this means of communication will be free from technological difficulties.
This authorization is valid until you notify the Student Wellness Centre in writing that you no longer consent to the use of virtual care. McMaster University also retains the right to terminate virtual care services at any time if, in the healthcare provider’s judgement, it becomes appropriate to do so.
COMMUNICATING BY ELECTRONIC MAIL (EMAIL), VOICEMAIL MESSAGE, AND TEXT MESSAGE
The Student Wellness Centre may communicate personal health information it deems appropriate via the email address you provide. Similarly, the Student Wellness Centre may communicate personal health information it deems appropriate via voicemail and text message to the telephone number you provide.
Communication of personal health information by email, voicemail, and text message will be at the discretion of the Student Wellness Centre staff members involved in your care. Email messages may contain (but are not limited to) laboratory requisitions, test results, and appointment information. Voicemail messages may contain (but are not limited to) test results, questions about your medical condition(s), and appointment information. Information communicated by text message will be minimal and brief, limited to appointment information and notification of missed telephone calls and emails. You shall immediately inform the Student Wellness Centre of changes to your telephone number.
The Student Wellness Centre email, voicemail, and text messaging services are general accounts, accessible by Student Wellness Centre nurses and receptionists. Emails, voicemail messages, and text messages are only monitored periodically. Significant time may pass without Student Wellness Centre staff viewing or responding to email, voicemail, and text messages. Health care providers can make no guarantee of a response, or a response within a certain time frame. Email, voicemail, and text messages are not appropriate for communication about all health issues, particularly those of an urgent or sensitive nature. If you have a serious psychological or medical emergency, you will use other means to seek help, whether or not that includes contacting the Student Wellness Centre. You understand that professional services will not be provided via email. Email communication or a summary of it will be retained as part of your health record and becomes the property of McMaster University. As a result, that information, including your email address and telephone number, may be disseminated as part of an authorized release of a copy of your medical record.
The Student Wellness Centre will use reasonable means to protect the privacy of your personal health information. Email, voicemail, and text messaging are not secure methods of communication; therefore, McMaster University cannot guarantee the security of messages that you send to or receive from the Student Wellness Centre. Emails, voicemail messages, and text messages are not encrypted. Email is not as confidential as mail or telephone communication. Voicemail is not as confidential as mail or direct telephone communication. It is possible for an unauthorized third party to intercept or listen to a voicemail message without the knowledge of either the sender or recipient of the message. It is possible for an unauthorized third party to intercept or read an email or text message without the knowledge of either the sender or recipient of the mail. Because of the ease and informality with which email can be used and because email may be easily forwarded to multiple addresses, the potential loss of confidentiality associated with its use may be of greater consequence than that suffered with written or telephone communication. You accept the risk of loss of privacy or confidential health information associated with communication by email, voicemail, and text message and nonetheless agree to its use. You also agree that any regulated healthcare professional and/or McMaster University shall not be liable for any type of damage or liability arising from or associated with loss of confidentiality due to communication by email, voicemail message, or text message. Since McMaster University does not operate or control any service on the internet, you understand that McMaster University cannot and does not guarantee that use of this means of communication will be free from technological difficulties, including, but not limited to, loss of messages.
This authorization is valid until you notify the Student Wellness Centre in writing that you no longer consent to the use of email, voicemail message, or text message to communicate personal health information. McMaster University also retains the right to terminate email, voicemail message, and text message as a means of communication at any time if, in the healthcare provider’s judgement, it becomes appropriate to do so.
MISSING HEALTH INSURANCE BILLING INFORMATION (FOR MEDICAL APPOINTMENTS ONLY)
If you are seen at the Student Wellness Centre and have not presented accurate health insurance billing information, you will be sent an invoice for payment for your visit. If you subsequently provide a health insurance number, which entitled you to coverage at the time of your visit, the invoice will be cancelled. Failure to either provide a valid insurance number, or pay the invoice, will lead to a fine applied to your student account.
THE STUDENT WELLNESS CENTRE WILL NOT CONTACT YOU REGARDING NORMAL RESULTS
The Student Wellness Centre will not contact you regarding investigations, including lab results, which are normal. We will contact you regarding any significant abnormal results. Otherwise, you may contact the Student Wellness Centre to confirm results if you wish to do so.
RESEARCH
McMaster University prioritizes research. Students may be approached to participate in research and have the right to refuse. This will not in any way impact the care provided at the Student Wellness Centre.
NO-SHOW AND CANCELLATION POLICY
We require at least 12 hours prior notice to cancel an appointment. Failure to attend an appointment without providing adequate notice of cancellation will result in a fee of $30.00, $50.00, or $100.00, depending on appointment length and provider type (physician, counsellor, or psychiatrist). Please see the Student Wellness Centre Fees guide for details. The Student Wellness Centre does attempt to remind students of upcoming appointments. You will receive a text message to your phone 48 hours prior to such an appointment. Not having received such a reminder is not a sufficient excuse for failing to attend a booked appointment. Your grades will not be released at the end of the academic year until all fees are paid. If you feel that you have been charged a “no show” fee in error, please submit this, in writing to the Director of the Student Wellness Centre.
DOWNLOAD THE STUDENT WELLNESS CENTRE PATIENT AGREEMENT
The Student Wellness Centre’s no-show and cancellation policy is outlined in the Patient Agreement form.
Reply to the text reminder by selecting the option to confirm (1) or cancel (2).
Call the Student Wellness Centre and choose the cancellation option.
Visit the clinic in person to cancel.
Text reminders are sent 48 hours before scheduled appointments. Please note that not receiving a reminder does not excuse a missed appointment. All outstanding fees must be paid before grades are released at the end of the academic year.
The non-medical use or abuse of prescription drugs is a serious and growing public health problem affecting both individuals and their communities.
Controlled substances, those most likely to be misused, include those with psychoactive properties such as opioids (codeine, oxycodone), stimulants (medications for ADHD such as methylphenidate and dextroamphetamines), and anxiolytics (i.e. Ativan/lorazepam).
These medications may be carefully prescribed for legitimate reasons however physicians also have a responsibility to try to reduce their inappropriate use.
The practice at the Student Wellness Centre when prescription for a controlled substance is being considered includes:
Collaborative efforts by all members of the McMaster community will reduce the negative impact of the inappropriate use of these controlled substances.
The Student Wellness Centre’s email policy is outlined in the Patient Agreement form.
The purpose of this policy is to define the limitations upon the use of cameras (including cell phone cameras), video recorders, audio recorders or any other type of equipment or devices used to capture or record visual and/or audio media and to ensure that the use of such devices does not compromise the integrity of Protected Health Information (PHI), proprietary information, individual rights to privacy, quality of patient care and the efficient operations of the Student Wellness Centre (SWC), McMaster University.
Camera or Audio/Video Recording Device – Any device that can capture and/or record visual images or audible conversations, such as but not limited to cameras, cell phone cameras, smart phones, computers, camcorders, video recorders and audio recorders.
Employee – Any individual employed directly by McMaster University, or any individual assigned to work for McMaster University.
Guest/Visitor/Student – Any individual who does not meet the definition of “Employee” above.
As with any policy, management employees are expected to serve as role models for proper compliance with the provisions above and encouraged to regularly remind employees of their responsibilities in complying with this policy. Employees are expected to obtain proper authorization prior to any use of such recording devices on the premises and to report any violations of this policy to their immediate supervisor. Employees who have visitors in the Student Wellness Centre are responsible for ensuring that the visitors are made aware of and adhere to this policy.
You may request that a copy of your medical records be sent directly to another healthcare provider/lawyer or yourself. Please note that a $30.00 fee applies to requests for copies of medical records, and requests may take up to 30 days to process.
For privacy and security reasons, we strongly encourage students to have their records sent directly to a healthcare provider, especially when a chart is large or contains extensive clinical information. Medical records include detailed clinical documentation intended to support healthcare providers in delivering and coordinating care. They may contain technical language, clinical observations, or sensitive information that can be difficult to interpret without professional guidance.
Sending records directly to a healthcare provider helps ensure your personal health information is shared and stored securely and allows your provider to review the information with you, answer questions, and provide context and support as needed. Please note that email is not considered a secure method for transmitting personal health information.
Additional identification may be required before records can be released.
Last Updated: February 23, 2026
Our office is committed to protecting the privacy, confidentiality, and security of your personal health information (PHI) in compliance with Ontario’s Personal Health Information Protection Act (PHIPA).
If our office cannot resolve your concern, you have the right to contact the Information and Privacy Commissioner of Ontario (IPC).