Program evaluation consent

Consent to Participate in Program Evaluation

The availability of this free CME accredited ECHO Canada Pain session (inset hub site name ex. at McGill University) is made possible by grant funding from Health Canada’s Substance Use and Addictions Program. In order to report on the effectiveness and value of the program, Dr. Andrea Furlan’s team at the University Health Network will be collecting aggregate data from all participants completing the ECHO Canada Pain sessions. We will be collecting and analyzing data from participant demographic information, pre-questionnaires and post-questionnaires. No personal identifying information will be used in any reporting or publications. All data will be securely stored at the University Health Network-Toronto Rehabilitation Network for a period of 10 years and will only be accessed by Dr. Andrea Furlan and her project team. Data can be withdrawn at any time by informing Dr. Andrea Furlan.

If you have any questions about this program evaluation study please contact the Program Manager, Yalnee Shantharam, at yalnee.shantharam@uhn.ca or 416-597-3422 x 3276. If you have any questions about your rights as a participant in this program evaluation study, you may contact the University Health Network’s Quality Improvement Review Committee (QIRC) at QI@uhn.ca