Thank you for your interest in the ECHO Education Event. 

All applicants will be notified about the status of their application 3-5 business days following submission. Please note filling out an application does not guarantee you a spot.

Click here for more information. 
SECTION A - APPLICANT INFORMATION

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* 1. Full Name

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* 2. Organization

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* 3. Job Title

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* 4. Phone Number

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* 5. Email Address

SECTION B - PROFESSIONAL BACKGROUND AND INTEREST

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* 6. What background or training do you already have in managing pain in children and youth?

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* 7. How will participating in this event support your professional development goals? What do you hope to achieve by participating?

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* 8. What acute or chronic pain topic(s) are you most interested in learning about?

SECTION C - FINANCIAL & SUPERVISOR SUPPORT

*Please note: to be eligible for financial support, applicants must have attended at least 3 Paediatric ECHO Sessions (Pain/Complex Care/Palliative Care/Obesity Management), or be a part of the Kids Health Alliance.

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* 9. Do you require financial support for travel-related expenses in order to attend this event?

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* 10. I am able to attend all 14 hours of this event.

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* 11. I have my supervisor's approval to participate in this event.

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