Have a concern or feedback? We want to hear from you!

Please use the attached form to report the following:

Privacy Related Concern(s):

  • Access to Personal Health Information
  • Request to Correct Personal Health Information
  • Request a Consent Directive – Lockbox
  • Request to Withdraw Consent
  • Privacy Incident or Complaint

Please note: General Privacy information can be found in “Privacy Policies” on our website and/or Questions can be directed to Privacyinfo@bancroftfht.com

General Concern(s):

  • Report an Incident
  • Complaint
  • Feedback


Send completed forms one of the following ways:
Address General Concerns to:
Sandra McGrath, Executive Director                    Address Privacy Concerns to: Angela Holbrook, FHT Privacy Officer


Drop off in an envelope to our secure drop box at the front doors of 19 Oak St. office OR
Address as above and mail to Box 1089, 19 Oak St. Bancroft, ON K0L 1C0