WHO ARE WE?
SHAPE Health and Wellness Centre Inc. (SHAPE), includes personal training, chiropractic, physiotherapy, registered massage therapy, spa services and other health and wellness services. We use a number of consultants and agencies that may, in the course of their duties, have limited access to personal information we hold.
Privacy of personal information is an important principle of SHAPE. We are committed to collecting, using, and disclosing personal information responsibly and only to the extent necessary for the goods and services we provide.
WHAT IS PERSONAL INFORMATION AND WHEN IS IT COLLECTED?
Personal information is information about an identifiable individual and includes information that relates to their personal characteristics (eg. gender, age, income, home address, telephone number, family status), health (eg. health history, health conditions, health services received) or activities and views (eg. religious, political, opinion expressed by an individual, opinion or evaluation of an individual). We are also committed to protecting employee information (name, title, business address or telephone number of an employee of an organization) with the same care as other personal information.
When you first enter SHAPE, we collect personal information that includes your full name, address, telephone number, e-mail address, and emergency contact information. Should you become a client of SHAPE, we collect personal information about you that may include medical information, information regarding your insurance coverage, and your credit card number so that we may provide you with any or all of our services. All information is collected with your consent.
WE COLLECT PERSONAL INFORMATION, BUT WHAT DO WE USE IT FOR?
Like all health and wellness centres, we collect, use, and disclose personal information in order to serve our clients. For our clients, the primary purposes for collecting personal information are as follows:
1. To offer and provide our services to you
2. To establish and maintain communication with you
3. To determine and facilitate your payment for programs and services
4. To notify you of programs, services, and upcoming promotions
5. To verify the accuracy of your Personal Information and ensure that it is up to date
6. To allow SHAPE to use the course and results of your treatment history for research and development purposes
SHAPE gathers only personal information that we deem necessary to administer our business, provide superior service, and communicate promotions and services that may be of interest to you.
1. SHAPE does not rent or sell client personal information to outside markets or marketers.
2. SHAPE will collect, use, and/or disclose personal information only for the purposes for which it was collected.
3. SHAPE will keep personal information only as long as necessary to satisfy the purposes of our business.
4. SHAPE safeguards your personal information (no matter in what form stored) against loss or theft, from unauthorized access, disclosure, copying, use, or modification. We will maintain practices and procedures designed to ensure and limit access to personal information to the purposes of the business.
CONSENT FOR PERSONAL INFORMATION
By completing this form I consent to the collection, utilization, and disclosure of my Personal Information. I understand that to provide me with Chiropractic / Physiotherapy / Registered Massage Therapy / Personal Training / Pilates / Yoga / Naturopathic / Nutritional and Counseling services, SHAPE will collect some personal information about me (eg., home telephone number, address).
For my protection, SHAPE will safeguard the access and storage of my personal information.
The Personal Information is retained only as long as necessary for the fulfillment of the above purposes. SHAPE is responsible for all Personal Information under its control and has designated a Privacy Officer who is accountable to the Board of Directors.
1. a notice when it is time to review whether I need new goods or services
2. receive newsletters and other informational mailing from SHAPE
3. receive notice of promotions and special offers from SHAPE
At any time, I may withdraw my consent at which time SHAPE will delete my Personal Information from their records. This also means that SHAPE will not be able to provide me with information about upcoming programs, services and promotions.
I understand, and acknowledge that sports and fitness, health and wellness, massage therapy and aerobic exercises, including the use of equipment, are potentially hazardous activities. I also understand and acknowledge that such health and fitness activities involve a risk of injury, including a remote risk of death or serious injury or disability and that I am voluntarily participating in these activities and using equipment and machinery with full knowledge, understanding, and appreciation of the risks and danger involved.
I hereby agree to expressly assume and accept any and all risks of injury or death that I may suffer, and hereby irrevocably release SHAPE Health and Wellness Centre Inc. and SHAPE Health and Wellness Centre York Mills Inc., its agents, officers and employees from any liability with respect to these risks while participating in a health and wellness program/physical activity. The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity. If in doubt after completing this questionnaire, please consult your doctor prior to physical activity.