This survey serves as your online application to join the OCFP's online community of practice for Medical Assistance in Dying (MAID).

This community of practice is open to physicians – including family doctors and specialists – pharmacists and nurse practitioners in Ontario, facilitating access to MAID experts and peers for case-based support and education. It is part of the OCFP’s Collaborative Mentoring Networks, supported by the Ministry of Health and Long-Term Care. Email ocfpmentoring@ocfp.on.ca to learn more.

Later in this survey, you will have the opportunity to indicate your interest in joining the MAID Mentoring Network as a Mentor or Mentee, or participating in the Community of Practice only. Note that the Mentoring piece of the MAID Network is in development.

The survey collects demographic information about you and your practice as well as your learning needs for continuing medical education.

The information you provide will help shape future program development. Thank you in advance for your participation.
About You

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* 1. Full name:

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* 2. Active email address which you regularly check:

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* 3. Your year of birth:

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* 4. Years in practice:

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* 5. You are:

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* 6. Which best describes you?

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