Registration for Peer Connect Small Group with Drs. Michael Pare and Nermine Gorguy

Thank you for your interest in joining a Peer Connect small group. Please complete the registration form below to join a small group facilitated by Drs. Michael Pare and Nermine Gorguy. This group will meet on the following dates (Fridays) from 9:30-11:00am via Zoom.

Friday, April 17, 2026
Friday, May 1, 2026
Friday, June 5, 2026
Friday, July 3, 2026
Friday, August 7, 2026
Friday, September 4, 2026
Friday, October 2, 2026
Friday, November 6, 2026
Friday, December 4 , 2026
Friday, January 8, 2027
Friday, February 5, 2027

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* 1. I commit to attending and participating in the group discussion dates listed above. Please note that participants who miss 3 consecutive sessions will be removed from the group. OCFP will send a reminder after 2 absences.

I agree.

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* 2. Please provide the following information:

First Name:

Last Name:

Email:

CFPC Number (for Mainpro+ credits):

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* 3. Please share topics/areas of interest you are hoping to focus on during these small group discussions.

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* 4. What challenges/barriers are you hoping these small group discussions can help you with?

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* 5. Identify your practice region:

Central Region 

Toronto Region

North East Region

North West Region

East Region

West Region

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* 6. Identify your practice model:

Family Health Group (FHG)

Fee for Service (FFS)

Family Health Network (FHN)

Family Health Organization (FHO)

Family Health Team – Family Health Network (FHT – FHN)

Family Health Team – Family Health Organization (FHT – FHO)

Comprehensive Care Model (CCM)

Community Health Centre (CHC)

Rural Northern Physician Group Agreement (RNPGA)

GP Focused Practice

Other (please specify):