Survey Introduction and Criteria

Tell us your personal story of recovery and courage and it may be used at a special event Celebrating Patients 2017 – More Than a Patient!.
  • Eligibility criteria for sharing your stories:


All patients willing to share their stories must be or have been a Mackenzie Health patient at Mackenzie Richmond Hill Hospital during the past five years.

All patients wishing to share their stories as part of Celebrating Patients - More Than A Patient! will be asked to sign a form giving Mackenzie Health consent to publish your personal stories on its website and/or other publications.

If your story is selected for our evening of art and storytelling on June 5, 2017 we will contact you to arrange for your participation in this very special event and to:
  • participate in a pre-taped videotaped segment  of  you sharing your story,  and,
  • be available to participate in the event on Monday, June 5, 2017 from 7:30 to 9:00 pm.
Not all stories will be able to be shared during our event on June 5, 2017. Some stories may be reserved for future opportunities such as the hospital website and/or publications. 

Please check the following box to confirm your consent and ability to meet the above eligibility criteria: Please check the following box to confirm your consent and ability to meet the above eligibility criteria:

* 1. I agree to the above eligibility criteria and agree to give my permission to Mackenzie Health to publish my personal story of my health journey.

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