MENTOR Registration: 2017 CMN Annual Conference & Mentors Meeting | November 24-25, 2017 - Toronto, ON

How to Remain Compassionate in the Face of Change

Thank you for your interest in attending the 2017 CMN Annual Conference & Mentors Meeting to be held at the Fairmont Royal York, Toronto.

Attendees will review the issues experienced by primary care physicians in providing care to patients with complex mental health, addiction and chronic pain co-morbidities, through the use of case-based discussions in both large and small interactive groups.

To view the Conference Agenda, please click here.

*Please note that the Mentors Meeting is only open to CMHN & MMAP Mentors*

Question Title

* 1. Please provide us with your contact information below.

First Name:

Last Name:

Email Address:

Association/Organization:

Address:

City/Town:

Province:

Postal Code:

Phone Number:

Question Title

* 2. Please indicate which Network you belong to:

MMAP Network

CMHN Network

Both Networks

Question Title

* 3. Which best describes you?

Family Physician

Family Physician with specific focus to your practice (e.g. ER, anesthesia, chronic pain) Please specify below

Psychiatrist

Medical Specialty

Resident

Other Health Professional (Please specify below)

Other (please specify)

Question Title

* 4. Do you have any Allergies and/or Dietary Restrictions?

Yes

If yes, please specify

Question Title

* 5. Please indicate which days you will be attending for the Annual Conference:

BOTH - Friday, November 24, 2017 & Saturday, November 25, 2017

ONLY Friday, November 24, 2017

ONLY Saturday, November 25, 2017

Question Title

* 6. Please advise if you will be attending the Annual Mentors Meeting on Friday, November 24, 2017 at 3:00 PM:

YES - I will be attending the Annual Mentors Meeting on Friday Afternoon

NO - I will not be attending the Annual Mentors Meeting on Friday Afternoon

Question Title

* 7. If you are attending the Conference on Saturday, November 25, 2017, please indicate below the sessions you will be attending in the morning from 10:00 AM to 11:00 AM:

Session A: Medical Marijuana - Dr. Jonathan Bertram

Session C: CBT on the Fly for Youth - Dr. Helen Spenser

Session E: Suboxone Prescribing in Primary Care (Naloxone/Buprenorphine) - Drs. Wiplove Lamba & Joel Bordman *Please Note: This session is a Workshop and will run from 10:00 AM to 12:00 PM therefore you must attend the full timeframe*

Question Title

* 8. If you are attending the Conference on Saturday, November 25, 2017, please indicate below the sessions you will be attending in the morning from 11:00 AM to 12:00 PM:

Session B: Alcohol Withdrawal - Dr. Lisa Bromley

Session D: Managing Difficult Behaviours in Children & Youth - Speaker TBD

Session E: Suboxone Prescribing in Primary Care (Naloxone/Buprenorphine) - Drs. Wiplove Lamba & Joel Bordman *Please Note: This session is a Workshop and will run from 10:00 AM to 12:00 PM therefore you must attend the full timeframe*

Question Title

* 9. If you are attending the Conference on Saturday November 25, 2017, please indicate below the sessions you will be attending in the afternoon from 1:00 PM to 2:00 PM:

Session F: Self-Management - Dr. Melissa Holowaty

Session H: Somatization - Dr. Kathy Gillis

Session J: Motivational Interviewing - Dr. Heather Flett *Please Note: This session is a Workshop and will run from 1:00 PM to 3:00 PM, therefore, you must attend the full timeframe*

Question Title

* 10. If you are attending the Conference on Saturday, November 25, 2017, please indicate below the sessions you will be attending in the afternoon from 2:00 PM to 3:00 PM:

Session G: Deprescribing & the Opioid Guidelines - Dr. Andrea Furlan

Session I: Adverse Childhood Experiences - Dr. Jon Hunter

Session J: Motivational Interviewing - Dr. Heather Flett *Please Note: This session is a Workshop and will run from 1:00 PM to 3:00 PM, therefore, you must attend the full timeframe*

Question Title

* 11. How did you find out about the Conference?

Flyer

Referral

Other, please specify

Thank you for confirming your attendance.

Please Note: All Mentors attending the Annual Conference on Friday night will be included in the 'Doctor Is In' Session