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Participant Authorization for the Transmission of Personal Information in the Québec Breast Cancer Screening Program (PQDCS, Programme québécois de dépistage du cancer du sein)

Information sheet, Form

Image for document cover.

Description

Every woman who wants to participate in the Québec Breast Cancer Screening Program (PQDCS) must fill out and sign the Participant Authorization for the Transmission of Personal Information in the Québec Breast Cancer Screening Program consent form. To be valid, the form must be filled out and signed on-site at a screening center every time a woman has a mammography as part of the PQDCS.

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(PDF, 174 Ko, 1 page)

Note that this information sheet is available in pads of 100 sheets. Only professionals and managers at health and social services institutions may order printed copies of this form.

This publication is available in French.

Details

Online since: March 14, 2017
Last modification: March 14, 2017

Author: MSSS

Publication no : 16-243-07A

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