The personal information requested on this form is collected under the authority of Section 4(c) of the Alberta Protection of Privacy Act (POPA) and will only be used for the purpose of tracking, follow up and communications regarding your request. For information about the collection and use of this information, contact Marketing and Communications at communications@covenanthealth.ca or the Covenant Health Information and Privacy Office at One Twelve Campus, 10130 112 Street NW, Edmonton, AB, T5K 2K4, Tel. 1.866.254.8181.

Covenant Wellness Community

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