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SickKids

General & Thoracic Surgery Fellowship Application

Personal information

Contact information

Current address

Permanent address

Education

Examinations

Type of license

General
Specialty
Educational

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Personal Information (PI) collected in this form will only be used for the purpose defined above and will only be retained for the period of time required to fulfill the purpose for which we collected it or as permitted and/or required by law. The hospital takes reasonable steps to protect your information from theft, loss and unauthorized use and/or disclosure. You may contact the General & Thoracic Surgery Education Coordinator if you have any questions about this form/program/process or if you do not want to provide any PI using the form. If you have general questions about the Hospital’s information practices, please contact privacy.office@sickkids.ca.

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