Privacy Impact Assessment - Management Structure Table

Management Structure Table (PIA Annotated Template - Section B)

Document Purpose and Overview

A Privacy Impact Assessment (PIA) describes how proposed administrative practices or information systems may affect the privacy of the individuals who are the subjects of the information. 

This document is intended to be adapted by the custodian when submitting a PIA in Section B: Management Structure Table. This table provides the Office of the Information and Privacy Commissioner (OIPC) an overview of the clinic’s organizational structure, including the various roles in the clinic and who they report to. 

The proper form to use is the PIA Annotated Template. This template is intended to assist community-based custodians in completing PIAs. It can be accessed on this page on the Alberta Health website.

Instructions for Use

• Below is an example of how to create a Management Structure Table
• Add roles as needed and fill in the relevant boxes

Example

Management Structure Table
Remove roles that do not apply to your clinic and fill in relevant details. When completed, add your table into the PIA Annotated Template.