Order Clinical and Patient Resources

Ready-made packages for your office

Public Health Program resources

Contact Information

* Name

* Name of practice or home

* Type of organization Select One... Family Practice Walk-in Clinic Hospital OB/GYN Midwifery Long-term care home Retirement home Pediatrician Other

Specify organization

* Phone xxx-xxx-xxxx

Ext.

* Email

Delivery Information

* Address

* City / Town Select City...Fort ErieGrimsbyLincolnNiagara FallsNiagara-on-the-LakePelhamPort ColborneSt. CatharinesThoroldWainfleetWellandWest Lincoln

* Postal Code

Notice of Collection

Any personal information or personal health information submitted will be collected, used, and disclosed, where applicable, by members of Regional staff according to the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act. Any information you share will only be used for the intended purpose for which it was provided.

For questions or comments about privacy practices, or for more information about the administration of the Municipal Freedom of Information and Protection of Privacy Act in Niagara Region programs, see Freedom of Information and Open Government.