Client Consent Form (Informed Consent)

Client Consent Form

Virtually Unlimited Inc.
Healthcare and Pharmacy Administration Services
Edmonton, AB, Canada

Last Updated: January 4, 2025

This form is to obtain your informed consent for the collection, use, and processing of your personal and health-related information required to provide the services offered by Virtually Unlimited Inc..

5.1 Services Provided

• Healthcare Administration: Includes medical records management, patient scheduling, etc.
• Pharmacy Administration: Includes prescription management, medication tracking, etc.

5.2 Consent to Collect Personal and Health Information

By signing this form, you consent to Virtually Unlimited Inc. collecting, using, and processing your personal and health-related information as required for the services above. Your information will be handled in accordance with the applicable privacy laws, including PIPEDA and the Health Information Act (HIA).

5.3 Acknowledgment of Risks and Benefits

You acknowledge that you understand the potential risks and benefits associated with sharing your personal and health information with Virtually Unlimited Inc. and agree to proceed with the services outlined.

*** A Similar Form will be sent to you before services are discussed and started ***