Consent for Collecting Personal Health Information

Kii Health (Santé) Inc. (“Kii Health”, “we”, “us”, “our”) is pleased to offer our Mental Health Coach service (the "Service") to you. The aim of the Service is to help you maximize the mental health benefits available to you. The service gives you the opportunity to take an online mental health assessment ("Assessment") and receive a corresponding care plan ("Care Plan"). You'll also have the option to meet with a mental health coach ("Mental Health Coach").

The Service is entirely voluntary and is being offered as an optional service available by your employer.

By choosing to participate in the Service, I understand that Kii Health may collect my personal information. This includes but is not limited to:

• Registration information, such as full name, date of birth, email address and phone number;
• Responses to the questions asked as part of the Assessment, which they need to build my personalized Care Plan
• Communications with my Mental Health Coach involving my mental health and Care Plan; and
• Benefit-related information, such as details of the coverage available to me.

I understand that by participating in the Service, I'll have the opportunity to provide personal responses to questions related to my mental health. I understand that I should only provide information that I'm comfortable sharing with Kii Health for the purposes of the Service. I should not provide any information that isn't necessary or connected to the administration of the Service.

I understand that Kii Health will use the personal information collected from my Assessment to create a Care Plan for me. They'll also use this information to recommend use of benefits in my plan and other resources. In particular, Kii Health will use and disclose my personal information identified in this Consent in the following ways:

• For authorized Kii Health management employees to manage the Service and analyze its effectiveness. Specifically, for the purposes of:
  • Assessing and improving the quality of Services provided;
  • Monitoring the rate of participation in the Service; and
  • Responding to inquiries about a Care Plan or participant experience.
  • For my Mental Health Coach to create my personalized Care Plan, which may include:
• Telephone conversations, if I choose to take part in them, with my Mental Health Coach. My Mental Health Coach will have reviewed my Assessment and will confirm my corresponding Care Plan. They'll base my Care Plan on information exchanged during our conversation(s);
  • Recommended treatment providers in my area or available remotely, which I may or may not choose to pursue;
  • Specific recommendations, as necessary. This includes, mental health-related reading materials and links to curated articles with information relevant to the issues identified in my Assessment;
  • Identification of treatment that I may have covered by my benefit plan; and
  • Follow-up communications with my Mental Health Coach, if I choose to participate in them. Communications will take place, over the course of 12-weeks after I get my Care Plan. This will include inviting me to participate in a re-assessment.
• To understand the interest and evaluate the Service, Kii Health will share limited aggregate, de-identified information with my employer. In particular, Kii Health will disclose de-identified data related to my level and type of engagement with the program, assessment level (i.e. mild, moderate, high), and my progress after I have completed the program. Under no circumstance will Kii Health share personally identifiable information about me with my employer without my consent or as required by law.

I understand that Kii Health reserves the right to share or withhold my personal information if required by law. This includes if disclosure is reasonably expected to be necessary to eliminate or reduce a significant risk of bodily harm to oneself or an identified person, or to comply with a court order.

I understand that Kii Health will maintain my personal information to protect the confidentiality of the information to the fullest extent possible. They'll meet all applicable privacy and data protection legislative requirements.

I understand that Mental Health Coaches will not provide me with treatment. I shouldn't rely on the information they provide for medical purposes. It's intended to give information that can help me manage my well-being. If I'm experiencing a medical emergency, I'm urged to call emergency services or go to the nearest hospital emergency department. Mental Health Coaches will only be providing me with names and contact information of treatment providers (such as psychologists and psychiatrists) who have the skills to provide treatment. They'll be within my community or online. I can then decide if I want to pursue treatment.

I understand that Kii Health is not responsible for and makes no warranty with respect to the opinions, advice, care or treatment provided by any treatment providers I ultimately see.

I understand that if I have any questions or concerns related to anything contained in this Consent or about Kii Health's Privacy Policy, I can contact the Kii Health Privacy Officer. Their contact information is located at privacy@cloudmd.ca.

I understand thatneither Kii Health nor any of its agents, directors, employees, proprietors, partners, representatives, servants, lawyers, successors or assigns will be liable for any indirect, incidental, special or consequential damages to me or to any other party arising out of the Service.

I acknowledge and agree that I have read, understood and agree to the above and consent freely and voluntarily. I also understand that I can withhold or withdraw my consent in writing at any time, in which case my information will be returned to me unless such return is restricted by law. I understand that withholding or withdrawing my consent will not affect any information already collected, used, disclosed or communicated.

By clicking on "I have carefully read and agree to the consent", I consent to the collection, use and disclosure of my personal information. This includes, personal health information, as described above.