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CareConnect Non-Health Authority Worksite Application Form

**Google Chrome is recommended for this form**
NOTE: If you are filling in this form for a Pharmacy, please use this form instead

The intent of this form is to collect feedback from participating community care providers on the set up, use and quality of CareConnect, the Provincial eHealth Viewer.

Participation is voluntary and will not directly impact patient care in any way.

This will take about 5 minutes of your time.

CareConnect Disclaimer

PHSA collects, uses and shares Personal Information only in accordance with the BC Freedom of Information and Protection of Privacy Act. All responses will be kept confidential and any reporting will be developed using aggregated and non-identifiable data. For any privacy related questions, please contact

Please contact for questions directly related to the form.