Enrolment Form. 1. I confirm that:
Enrolment Form. During the term of this Agreement, patients who are invited to enrol in accordance with sections 3.1 and 3.2 shall be provided with the patient Enrolment Form and Consent to Release Personal Information, in the form appended hereto as Appendix A. The Enrolment Form shall become effective upon its completion and signing by the patient and the acknowledgement of the FHN Physician thereon. Upon the full completion of the Enrolment Form by the patient and the FHN Physician, the FHN Physician shall provide a copy to the patient. In the event that the FHN Physician is a Medicine Professional Corporation, patients shall be assigned to an individual voting shareholder designated by that corporation to act as its agent for the purposes of enrolment, including completing with the patient the Enrolment Form.
Enrolment Form a. I confirm that: i. I am the person with lawful authority and/or Parental Responsibility of the Child nominated on the Enrolment Form; and
Enrolment Form. During the term of this Agreement, patients who are invited to enrol in accordance with sections 3.1 and 3.2 shall be provided with the patient Enrolment Form and Consent to Release Personal Information, in the form appended hereto as Appendix A. The Enrolment Form shall become effective upon its completion and signing by the patient and the acknowledgement of the FHN Physician thereon. Upon the full completion of the Enrolment Form by the patient and the FHN Physician, the FHN Physician shall provide a copy to the patient.
