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Application Form for
Special Access Cards and Electronic Single Access Permits for visitors to
Cranston Ridge Medical Clinic & Cranston Smart Drug Mart

Cranston Ridge Medical Clinic and Cranston Smart Drug Mart adopt a very high standard of security within their premises. This means that unless you are a patient booked for the day, in order for you to access any areas inside the building past the reception desks, you require a permit. Exception made only for employees, volunteers, and students of CRMC/CSDM, inspectors from the Ministry of Health or Ministry of Labour, and law enforcement officers.

 

In order for us to release to you an electronic Single Access Permit (eSAP) or Special Access Card (SAC), if you plan to be a frequent visitors, you must fill out this form and upload the required documentation mentioned in it. The information is collected on a PIPA-compliant secure server and it is kept for three years after you leave the agency/employer you come to represent at CRMC on your visits. This information may be shared with the police on their request if they deem it necessary for any investigations.

 

Please be advised that if a member of staff of CRMC or CSDM asks you to leave the premises, you must do so immediately under penalty of trespassing. In addition, CRMC/CSDM reserve the right to cancel your SAC or eSAP at any time and for any reasons.

This application form is PIPA-compliant.

 

PLEASE NOTE THAT IF YOU ARE PLANNING TO WORK AT CRMC ON BEHALF OF A PARTNER AGENCY OR CLINIC, THIS FORM IS NOT FOR YOU. INSTEAD, YOU WILL HAVE TO APPLY VIA A DIFFERENT PROCESS THROUGH YOUR EMPLOYER WHO ALREADY HAS AN ESTABLISHED AGREEMENT WITH CRANSTON RIDGE MEDICAL CLINIC AND CRANSTON SMART DRUG MART.

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Before completing the application below, please take vision of the following two links.

Date of Birth of Applicant
Year
Month
Day
I am applying for:
A Special Access Card (SAC)
An electronic Single Access Permit (eSAP)

SAC - this permit is for frequent visitors; you must apply up to 72 hours before visiting the first time - the card is valid until canceled or until you resign from your position at the agency you regularly come to CRMC to represent, whichever occurs first.


eSAP - this permit is for one-off visitors; apply up to 24 hours before visiting - this permit is valid only for one visit on a specific date and time; once you leave the premises, you are no longer re-admissible on the same permit.

Date of Application
Year
Month
Day
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

You may use your mouse to sign inside the box, or you may choose to upload your signature as a file, or you may choose to type your signature. All three forms are legally accepted in Alberta.

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