*1.Full name:(Required.)

*2.CKO Registration number:(Required.)

*3.Email address:(Required.)

*4.Your practice information:
(Refer to CKO website for more details)(Required.)

Clinical (Providing direct patient/client service or care)

Non-Clinical (Not providing direct patient/client service or care)

Mixed (Involving some elements of both)

*5.Each Peer Circle session will last for 1.5-2 hours. Participants are expected to meet four times over a six-month period from October 2023 to March 2024.(Required.)

Morning (between 9 a.m. to 12 p.m.)

Afternoon (between 12 p.m. to 3 p.m.)

Evening (between 5 p.m. to 8 p.m.)

*6.The following topics will be covered in the upcoming Peer Circle cycle, please list your learning goals or needs for each topic.(Required.)

Virtual Treatment, Care and Services:

Scope of Practice:

Consent:

Discharging a Patient/Client: