DISCLAIMER
SCREEN EASY
By filling out this form, you agree to provide your name and phone number to the Mississauga Halton Central West Regional Cancer Program (MHCW RCP) to call you by phone and explain the "Screen Easy" program. "Screen Easy" can help you find a family doctor and/or book a cancer screening appointment with your doctor or a mammogram clinic. Please note that this form is not secured.
Screen Easy is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your condition.
SURVEY MONKEY
By consenting to complete this form through SurveyMonkey, you agree to share your personal information that you submitted with this online survey provider and they may use this information for their corporate purposes. Please review SurveyMonkey's privacy policy before completing the survey.
By filling out this form, you agree to provide your name and phone number to the Mississauga Halton Central West Regional Cancer Program (MHCW RCP) to call you by phone and explain the "Screen Easy" program. "Screen Easy" can help you find a family doctor and/or book a cancer screening appointment with your doctor or a mammogram clinic. Please note that this form is not secured.
Screen Easy is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your condition.
SURVEY MONKEY
By consenting to complete this form through SurveyMonkey, you agree to share your personal information that you submitted with this online survey provider and they may use this information for their corporate purposes. Please review SurveyMonkey's privacy policy before completing the survey.