You are receiving this survey because you are on the gloriousdeaths.org mailing list for the Ontario community of practice for Community Death Care. We are interested in surveying our members' interests and expertise towards future educational events and meeting themes. 

What is your first name?

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* 1. What is your first name?

What is your last name?

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* 2. What is your last name?

At what email address would you like to be contacted?

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* 3. At what email address would you like to be contacted?

Areas where you would like to learn more. Please check your top three or four choices. Or add other options below.

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* 4. Areas where you would like to learn more. Please check your top three or four choices. Or add other options below.

Areas where I can offer leadership/expertise

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* 5. Areas where I can offer leadership/expertise

At each community of practice gathering there is a significant time set aside for reflection on a theme. Past themes have included surrender, acts of tenderness at the time of death, taking care of yourself. Do you have a suggestion for a future theme?

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* 6. At each community of practice gathering there is a significant time set aside for reflection on a theme. Past themes have included surrender, acts of tenderness at the time of death, taking care of yourself. Do you have a suggestion for a future theme?

Anything else to share?

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* 7. Anything else to share?

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