Thank you for your interest in participating in the Peer Circles Pilot Test. We will try to accommodate as many participants as possible!

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1. First Name:

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2. Last Name:

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3. Registration ID Number:

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4. Please select your availability:

 
Sunday, September 17 from 2-4 p.m. (In-person)
Monday, September 18 from 1-3 p.m. (In-person)*
Tuesday, September 26 from 6-8 p.m. (Zoom)*
*These sessions will be filmed, and participants will be asked to sign a waiver.

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5. Practice Location:

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6. How many years have you been practising?

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7. Current practice setting (select all that apply):

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8. Do you currently, or have you previously, worked with Indigenous or remote/under-serviced communities?

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9. Are you fluent in French?

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