PIRN Membership Form

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Pediatric Inpatient Research Network (PIRN) is a group of physicians and researchers in Canada who work with children and families to generate evidence that improves care and outcomes for hospitalized children in general pediatric setting. We invite you to become a PIRN member and receive updates about various events and opportunities offered by PIRN.

For more information, please visit the PIRN website.

First name *

Last name *

Email address *

Are you a: *

Health Care Professional

Clinician Scientist

Researcher

Interested Parent

Interested Youth (up to age 26)

Graduate Student or Trainee (please visit https://www.pirncanada.com/become-a-trainee)

Other:

If applicable, what hospital are you affiliated with?

If applicable, which university are you affiliated with?

How did you hear about PIRN? *

Faculty

Colleague

Friend

Conference/presentation

Social media (e.g. Twitter)

PIRN website

Link on a survey

Other:

Required

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