Required fields are marked with asterisks (*)

Text-Email Consent

You are invited to use texting and/or email (in addition to phone calls) as a way to communicate with your worker.

You can text and email staff at Social Services for general information such as:

Setting up appointments
Receiving appointment reminders
Receiving reminders to submit information
Sending copies of documents
Asking general questions about your case file
Finding out about office hours
Getting agency information and/or referrals to other agencies

Guidelines to be aware of:

Texts and emails can be received by staff during office hours, Monday to Friday except when our office is closed.
Our goal is to reply within one business day.
If you do not hear from us within one business day, please contact the office by phone.
Your email communications will become part of your case file. Your electronic file is stored on secure provincial servers.
Your case information will not be released - you will still have to phone or use the IVR for information regarding eligibility and payments.
No personal information will be exchanged (like health card, SIN and member ID).
Text and email may be used to advise of upcoming appointments.
Text and email may be used to book appointments.
Text and email may be used to remind you to submit required information.
Text and email does not include voice mail. To leave a voice message for your worker, please call 705-748-8830.

Remember: to please let us know if your phone number or email changes.

To begin using email and/or text to communicate with Social Services staff please complete the following consent form.

First Name

Last Name

Street Address

City

Postal Code

Case Manager Name

Please select today's date.

I acknowledge that I have read the information contained within this form about text and email guidelines.

I Acknowledge

I consent to contact through email and or text with Social Services staff.

Text and Email

Text

Notice with Respect to the Collection of Personal Information (Municipal Freedom of Information and Protection of Privacy Act)

Personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25, or Ontario Disability Support Program (ODSP, 1997), or the Ontario Works Act (1997), or the Childcare and Early Years Act (2014) for the purpose of administering social assistance and childcare programs. For more information contact the Program Manager at (705) 748-8830 or socialservices@peterborough.ca.