PNW LOCUM NETWORK

By completing the survey below, you will be added to the PNW Locum Network contact list of locum providers for the Pacific Northwest Division of Family Practice.

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* 1. Please provide your contact information

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* 2. Are you currently registered with the College of Physicians and Surgeons of BC?

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* 3. When would you like to provide coverage (dates available)?

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* 4. Which communities in the pacific northwest are you interested in providing locum coverage? Please select all applicable:

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* 5. Thank you for joining the PNW Locum Network and for sharing your information and availability.  We will be in touch with you shortly.   If you have any additional comments, please enter these below:

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