Course Instructor: Brenda Lynn Morgan 
Course Platform:  Combined online and live Zoom

PLEASE READ BEFORE BEGINNING REGISTRATION 
To avoid delays, please confirm that you have the correct email address for the Etransfer: critcareconcepts@rogers.com 

Please add Brenda Morgan Email: critcareconcepts@rogers.com to your contact list to reduce the chance that emails may be lost in SPAM.

If you do not receive confirmation of receipt of your payment within 5 days, please email Brenda Morgan to confirm that it was received.  When registrations fail to arrive, it is almost always an error in the email address.  When this happens, the sender never receives bank notification that the deposit was accepted (even though the money has been removed from the senders account) and the receiver is unaware that a transfer was sent. The sender will eventually (usually 30 days) be notified that the deposit was never completed and the money returned to the sender's account.  If you do not receive a receipt for payment within 5 days, please contact critcareconcepts@rogers.com

Members of the Canadian Association of Critical Care Nurses (CACCN) are eligible for a $20.00 discount.  Prior to completing the registration, you must login to the CACCN members only website to obtain the discount code.  You will need this to complete this registration (discounted rates will not be reimbursed after registration). 

A 20% cancellation fee will apply if requested by email, before the course material has been sent. No refunds after this date. Course material and access to the live sessions are restricted to registered participants. 

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* 1. FIRST NAME

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* 2. What is the CACCN Discount Code (from CACCN members login site). This is mandatory to receive discounted rate.

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* 3. LAST NAME

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* 4. PREFERRED EMAIL (Personal email is recommended; used for all course instructions, receipt, handout links, ZOOM links,  Continuing Learning Hours and important course notifications. Work emails will often trap correspondence in firewalls or SPAM filters.)

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* 5. ALTERNATE EMAIL (OPTIONAL)

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* 6. ADDRESS

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* 7. CITY

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* 8. PROVINCE

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* 9. POSTAL CODE

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* 10. HOME PHONE (Mandatory for emergency contact of course changes)

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* 11. MOBILE PHONE (FOR EMERGENCY NOTIFICATION)

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* 12. PRIMARY WORK PHONE 

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* 13. PRIMARY EMPLOYER

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* 14. I understand that access to this online course is restricted to single registered particpants only. Passwords cannot be shared.

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* 15. Payment Option (handout links and course registration information will be sent after payment has been received).

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* 16. What is the security password for your Etransfer? Security codes are case sensitive.

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* 17. Registration Fee

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* 18. If paying the CACCN rate, what is the CACCN member code? 

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* 19. I understand that handout material cannot be reproduced (in whole or in part) without permission from Critical Care Concepts.  I am also aware that access to online course material is restricted to registered participants. 

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* 20. Course content is provided for educational purposes only. Critical Care Concepts assumes no responsibility for the application of content in the clinical area or for the clinical decision-making of any participant. 

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* 21. I am aware that videos will only be available until July 31, 2023.  I am aware that each ZOOM follow-up classes will only be offered live once, but a recording will be available for a period of 14 days. 

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* 22. I am aware of the cancellation policy (20% cancellation fee if email notification made prior to receipt of course material link). No cancellation after this date. Courses are non-transferrable.

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* 23. Where did you hear about this course?

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