Participant Registration Form

Course date and location:
Saturday September 22, 2018, 1:00 - 5:00 p.m. 
Saskatoon City Hospital, 701 Queen Street
Cafeteria Side Room, Level 0
 
This course will be held immediately following the 64th Family Medicine Conference hosted by the Saskatchewan College of Family Physicians.   

Registration deadline is September 13, 2018.  Seating is limited; please register early.


First Name

Question Title

* 2. First Name

Last Name

Question Title

* 3. Last Name

E-mail address (to contact you regarding this course)

Question Title

* 5. E-mail address (to contact you regarding this course)

Mailing Address

Question Title

* 6. Mailing Address

City

Question Title

* 7. City

Province

Question Title

* 8. Province

Postal Code

Question Title

* 9. Postal Code

Phone Number

Question Title

* 10. Phone Number

As part of CME accreditation requirements, we would like to better understand your primary learning needs.  Of the following, please select all that apply.  What are your learning needs for the Spine Training course?

Question Title

* 11. As part of CME accreditation requirements, we would like to better understand your primary learning needs.  Of the following, please select all that apply.  What are your learning needs for the Spine Training course?

Thank you for registering!  A registration confirmation will be sent to you at the e-mail address provided.

Questions?  Please contact SpineTraining@health.gov.sk.ca.

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