Part 1: Clarifying Confidentiality & Basic Contact Info

Personal Information on a Provincial  Database

The AIDS Committee of Toronto (ACT) uses the Ontario Community-Based Service Evaluation (OCASE) database to collect and store information related to ACT’s services users and the programs they access. This includes personal information such as your name, age, contact information, HIV status, and information about your use of ACT programs and services. By collecting this information, we are able to easily track our work with service users across the agency and better monitor and manage our programs and services.

We need your consent before we can use OCASE to record any personal information related to you and your use of ACT services. If you do not consent to ACT recording your personal information in our OCASE database, we will provide you with a unique identifier in order to record non-identifying information about you and your use of our programs and services. Without your consent, personally identifying information (your name and contact information) will not be recorded in OCASE.

Who can see my personal information in OCASE?

The information you provide to us is stored securely on a password protected server, accessible only at ACT’s offices. Only authorized ACT staff members can access the personal information recorded in our OCASE database. This includes ACT management and ACT support staff.

ACT will never share your personal information with a third party without explicitly obtaining your consent to do so.
 

Personal Information on Totally outRIGHT Program Tools and In Running the Program

Any hard copies of our other evaluation tools we use during the program which has your personal information, such as your name and contact information will be destroyed within a year after the program has ended. To maintain confidentiality, hard copy information will be stored in a secure location in our offices that can only be accessed by the program's staff and supervisors.  

We will keep summarized versions of participants’ information. (e.g. "There were seven 26 year old participants.") This is used to assist us with measuring our program’s success, to plan future Totally outRIGHT events, to advertise the program, and to share with researchers and social service agencies that run events for young people.

ACT fully respects participants' individual confidentiality as prescribed by law.  There are times when we would be required to share information about you specifically – those times would include if you told us you were going to harm yourself or someone else; you tell us about child abuse; or your information is subpoenaed by the courts.

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* 1. Do you consent to ACT recording your personal information in our OCASE database? Note:You can still participate in the program if you indicate "No." (Please indicate "Yes" or "No")

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* 2. If you have any concerns regarding confidentiality please make those clear to us below:

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* 3. Totally outRIGHT uses group activities, and asks the big group to create group norms. These norms typically look like this: Respect each other's confidentiality. Share speaking time. Anyone can opt out of an activity without judgment. Respect differences of opinion and tastes. Use I statements and speak from your experience. Ensure a safe space for each other. Is this a framework you would feel comfortable working with? 

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* 4. If you have any concerns regarding group norms please make those clear to us below:

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* 5. Please provide your name:
(Note: the name you provide us will be used on all documents including your graduation certificate, unless you specify another name you would like us to use on the certificate prior to graduation.)

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* 6. What is your preferred name? (if different than above):

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* 7. What is your preferred pronoun?
(e.g. he, her, or they) Note: some guys might prefer a gender-neutral pronoun or no pronoun.

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* 8. Totally outRIGHT is for participants aged 18 to 29. What is your age?
Note: Older participants similar in age may be able to participate pending available room.

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* 9. What is your birth date?
(This is optional, if you prefer not to provide this information please leave this question blank.)

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* 10. Please provide an email address and phone number.
Note: We will absolutely need an email address. We have had trouble in the past with applicant junk mail filters being so stringent that our emails have ended up in junk mail folders.  Please set your email filters (white list) any emails that contain "actoronto.org" in them.  As an added precaution we suggest you check your junk mail as well as your regular email boxes during the duration of the program to ensure our messages are not being missed.  

Providing your phone number is needed as well.  We will likely use it if we find that you are not responding to emails.

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* 11. If you have given us a phone number, may we leave a message for you? (Please think about the name you have shared with us, as well as if your sexual orientation or the gender you identify is known to the people who have access to this number. Consider if our leaving you a message will cause you any problems before indicating “Yes.”) 

Note: If you indicated “No” we will not leave messages at the number you provided. We will ask only to speak to you, and if someone else picks up the phone and asks why we are calling,we will tell them that our call is regarding an inquiry you made regarding a leadership course.

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 25% of survey complete.

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