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Consent to Disclosure of Personal Health Information

By submitting a booking form I hereby (i) confirm that I have had the opportunity to read the privacy statement contained on this website, (ii) consent to the collection and use of the personal information, including personal health information, contained herein, (iii) acknowledge that Michelle Gelok may be required to disclose my personal health information in connection with a regulatory requirement of the College of Dietitians of Ontario or as otherwise required by law, and I hereby consent to such disclosure.

Last updated November 5, 2018

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