JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
HIV Primary Care Follow Up Workshop
Questions about this event or the registration process can be directed to
amanda.galambos@sidcn.ca
There is no cost to attend this event.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Participant Information
First Name
*
Your answer
Last Name
*
Your answer
Profession
*
Primary Care/ Family Physician
Medical Resident
Nurse Practitioner
Registered Nurse
Other:
Where are residing and/or practicing?
Your answer
Food Allergies (if applicable)
Your answer
HIV Experience
In the last 12 months, how many people living with HIV have you seen/provided care to?
*
None
1-5
5-10
10-20
20+
Other:
Which HIV Primary Care Education Opportunities provided by the Saskatchewan Infectious Disease Care Network have you participated in? Check all that apply
HIV Virtual Classroom
HIV Physician Preceptorship
March 8, 2019 HIV Primary Care Workshop in Saskatoon
November 16, 2019 HIV Primary Care Workshop in North Battleford
Plan on attending the March 28, 2020 HIV Primary Care Workshop in Prince Albert
I have not attended any prior educational opportunities provided by the Saskatchewan Infectious Disease Care Network, but I have previous/current experience treating HIV and/or HCV
Other:
Learning Goals
What are your learning goals and motivation for attending this workshop?
*
Your answer
Additional Comments
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
