I hereby confirm that the above information is true and correct and that the Health Card Number is current and valid.
By supplying my home/cell phone number, email address and any other personal information, I authorize New Life Fertility to use my personal information to contact me with respect to appointment times, referral notices, result information, appointment reminders, and other limited information. I am also aware it is my responsibility to keep my contact information current.
Please note, our clinic does not adopt the result policy of “no news is good news”. I acknowledge that I am responsible for following up on all test results.
I acknowledge that I am responsible for the payment of all charges for any treatment that may not be paid or covered by my provincial health care plan or insurance, ie. Insurance forms, driver’s physicals, sick notes, employment and sports physicals and transfer of records.
I hereby acknowledge that the medical or other healthcare treatment received by myself from New Life Fertility and any of its physicians will be provided in the province or territory of Ontario, and that courts of Ontario all have the exclusive jurisdiction to hear any complaint, demand, claim, proceeding or cause of action , whatsoever arising from or in connection with that medical or other healthcare and treatment, or from any other aspect of the relationship between the physician and myself.
I also agree that any and all disputes arising from or in connection with that relationship, including any disputes arising under or in connection with this agreement, shall be governed by and construed accordance with the laws of the province or territory of Ontario (other than conflict of laws rules) and the laws of Canada applicable therein.
I authorize this medical practice to access my health information recorded elsewhere – including Pharmanet Medication Profile – for the purpose of providing care and treatment. This consent will continue until I revoke it in writing.
Appendix A - Risks of using electronic communication
The Physician will use reasonable means to protect the security and confidentiality of information sent and received using the Services (“Services” is defined in the attached Consent to use electronic communications). However, because of the risks outlined below, the Physician cannot guarantee the security and confidentiality of electronic communications:
Conditions of using the Services
Instructions for communication using the Services
To communicate using the Services, you must:
Last Updated: June 5, 2025
1. What is this document?
This TOS is a legal agreement between:
This TOS governs your access to, and use of, our website at cortico.ca (the “Website”) as well as our online patient engagement platform and booking service provided through other websites and devices (together, the “Programs”).
2. What are you agreeing to?
By clicking “I accept”, you accept this TOS and our Privacy Policy. If you do not agree to this TOS, please do not use or access the Programs or the Website.
3. Who may use the Website or the Programs?
You may only use the Website if you are over the age of digital majority in your country (for instance, over 13 years old in California).
You may only use the Programs if you are at least 16 years old and a patient of a medical services provider who is using the Programs to schedule appointments or otherwise interact with you.
4. The Programs are only tools!
The use of the Programs is not intended to replace the advice of a medical professional or other qualified healthcare provider. We do not intend to create a medical professional – patient relationship with you.
The Programs do not provide an emergency or crisis response.
5. How do we handle your Personal Information and what can you do with it?
When using the Programs, you may provide us with certain information ("Personal Information"). We treat all such information as confidential and process it in accordance with our Privacy Policy.
You control your Personal Information and may share, download, export, correct or delete it using the Programs or upon request.
6. How may your access to the Programs end?
If you violate the terms of this TOS, we may issue you a warning for violation of this TOS, temporarily block your use of the Programs, or (if the violation is severe) immediately terminate your access to the Programs.
We also may immediately terminate your access to the Programs if we are no longer providing this functionality to the medical services provider of which you are a patient.
You may terminate your use of the Programs at any time. If you do, we will delete all your Personal Information, unless applicable law requires us to retain it.
7. Our liability is limited!
We don’t make any warranties, representations or conditions of any kind, including those regarding non-infringement of third party rights, durability, merchantability, or fitness for any particular purpose.
In no event will we be liable to you for any consequential, incidental or special damages, including any lost profits or lost savings.
8. What if something goes wrong?
When you agree to this TOS you are agreeing to resolve any dispute between you and us by arbitration or mediation. You are waiving your rights to a trial by jury.
All disputes in connection with this TOS will be referred to and finally resolved by arbitration or mediation under the rules of the British Columbia International Commercial Arbitration Centre.
The place of arbitration or mediation will be Vancouver, British Columbia, Canada.
9. What else do you need to know?
We may modify this TOS at any time and will notify you of the change via your chosen preferred channel specified in the Programs, or upon your next use of the Programs. If you access the Programs after the change has taken effect, you are deemed to have accepted the change.
This TOS and our Privacy Policy contain the entire understanding between you and us with respect to the Programs.
This TOS is governed by the laws of the Province of British Columbia, Canada.