Registration for Peer Connect Small Group with Drs. Rachel Shour 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. Rachel Shour and Nermine Gorguy. This group will meet on the following dates (Tuesdays) from 4:00-5:30 PM via Zoom.

Tuesday, April 21st, 2026
Tuesday, May 12th, 2026
Tuesday, June 9th, 2026
Tuesday, July 21st, 2026
Tuesday, August 11th, 2026
Tuesday, September 15th, 2026

The remainder of the group dates will be decided later in the year.

*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.(Required.)

I agree.

*2.Please provide the following information:(Required.)

First Name:

Last Name:

Email:

CFPC Number (for Mainpro+ credits):

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

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

5.Identify your practice region:

Central Region 

Toronto Region

North East Region

North West Region

East Region

West Region

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):

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