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Ask about LEEP (Lived Experience Expert Panel)

Are you interested in joining LEEP, or would you like to find out more information? 

Please complete the form below to submit your name and contact information. Be sure to include your full name, phone number, and email address.

A LEEP staff person will contact you in 1-3 business days. 

If you need help to complete this form, please call us at 1-888-221-2133 during regular business hours.

Your information

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The best time of day to contact me is:
 

Your information, including any personal health information, is collected, stored and disposed of in accordance with the Health Protection and Promotion ActMunicipal Freedom of Information and Protection of Privacy ActPersonal Health Information Protection Act, and health unit policies. Huron Perth Public Health (HPPH) is committed to ensuring that your personal and health information is private and safe. We are the sole owner of information collected on our website. Your information is only kept for as long as required. We do not use or keep personal information for any secondary purposes, unless prior permission and notification is provided.

Questions about this collection of information should be directed to the Privacy Officer of Huron Perth Public Health by calling 1-888-221-2133 or emailing privacy@hpph.ca.

By checking this box, I acknowledge that I have read, understand, and agree that the information provided in this form is correct.
 


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