Collection and use of personal information in this request form is in accordance with the federal Privacy Act.
The personal information you provide is collected under the authority of the Department of Health Act for the purpose of providing you with a radiation dose history. Requests from a third party for any employee dose history will only be provided with the written consent of the employee. This collection of personal information is described in Info Source under the Personal Information Bank (PIB) HC PPU 080 - National Dose Registry for Occupational Exposures.
Health Canada will be unable to process your request if you fail to complete the required fields in this request form.
The Privacy Act gives you the rights of access to, correction of and protection of your personal information. For further information about this Privacy statement please contact Health Canada's Access to Information and Privacy Coordinator. A list of all ATIP Coordinators across the federal government is available at http://www.tbs-sct.gc.ca/atip-aiprp/apps/coords/index-eng.asp.
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