The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act (“Act”) and will be protected under Part 2 of the Act. The information is collected for the purpose of the booking and efficiency of the appointment process, to follow up on inquiries, and to contact you in regards to services provided. If you have any inquiries in regards to the collection of your personal information, please direct those inquiries to: FOIP Coordinator, University of Lethbridge, 4401 University Dr. West, Lethbridge, Alberta T1K 3M4, telephone: 403-332-4620, email: foip@uleth.ca.