Please complete the survey below to help cSBC develop engaging public-facing material.
Disclaimer: please do not provide any confidential information.

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* 1. Patient age (exact or approximate in years)

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* 2. Patient Gender

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* 3. How long has this patient been waiting to initially see you (wait time in months on waitlist)?

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* 4. What condition or differentials was this patient waiting to see you for? What was the diagnosis?

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* 5. Are you aware of any harm that has occurred to this patient because of the long wait time to initially see a specialist? (ex. condition worsened) How has the patient been impacted as a result of waiting?

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* 6. What is your Specialty/Section?

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* 7. Not a cSBC member yet? Join Now! Membership includes new benefits such as, Health & Dental coverage, SR&ED Credit Support, plus more tools and advocacy resources.

Please share your email with cSBC to stay connected and receive updates for Specialists. *Note: this form is separate from membership sign-up.

Together, we are stronger. Thank you for helping improve access to Specialist Care.

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