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Contact Information
Name
*
First
Last
Email
*
Phone
Professional Background
What is your area of specialty?
*
Nursing
Allied Health and Supporting Professions
Physician
Please choose your profession below.
*
Licensed Practical Nurse
Midwife
Nurse Practitioner
Registered Nurse
Registered Psychiatric Nurse
What are your preferred areas of nursing?
*
Acute Care – Medical
Acute Care – Obstetrics/Gynecology
Acute Care – Orthopedics/Oncology/Burns/Cardiac-PCU
Acute Care – Pediatrics
Acute Care – Rehabilitation
Acute Care – Surgical
Acute Care – Stroke
Cancer Care
Critical Care – ICU/CCU
Emergency Care – Ambulatory Care – Endoscopy/Ophthalmology/Same Day Treatment
Home Care
Interprofessional Practice & Learning – Clinical Nurse Educator/Practice Leader
Long-Term Care
Mental Health & Addictions – ED Crisis response
Mental Health & Addictions – Inpatient Withdrawal Mngt
Mental Health & Addictions – Intensive Day Program
Mental Health & Addictions – Psychiatry
Mental Health & Addictions – Residential and Day Structured Programs
Mental Health & Addictions – Acute Inpatient
Nursing Leadership Opportunities
Operating Room
Orthopedic
Palliative Care
Primary Care – Including Regional Networks/Patient Medical Homes/Chronic Disease Management Programs
Provincial Nursing Float Pool
Public Health Nursing
Renal, Hemodialysis, or Nephrology
Sexual Health, Options & Reproductive Services (SHORS)
Please choose your profession below.
*
Addiction Worker
Anesthesia Assistant
Audiologist
Biomedical Technologist
Child Psychologist
Clerk
Clinical Chemist
Counselling Therapist
Counselling Psychologist
Dental Hygienist
Dietitian
EEG/ECG Technologist
Food Services
Health Information Management (HIM) Professional
Home Support Worker (HSW)
Housekeeping
Kinesiologist
Laundry
Maintenance
Medical Laboratory Assistant (MLA)
Medical Laboratory Technologist (MLT)
Medical Radiation Technologist (MRT)
Magnetic Resonance Imaging Technician (MRIT)
Medical Secretary / Medical Office Assistants (MOA)
Medical Transcriptionist
Occupational Therapist (OT)
Occupational Therapy Assistant (OTA)
Orthotists/Prosthetist
Pathology Assistant
Personal Care Worker (PCW)
Pharmacy Technician
Phlebotomy (Venipuncture) Tech
Pharmacist
Physiotherapist (PT)
Physiotherapy Assistant (PTA)
Porters
Psychologist
Registered Cardio Technologist (RCT)
Rehab Assistant (RA)
Resident Care Worker (RCW)
Respiratory Therapist (RT)
Service Worker
Social Service Worker
Social Worker
Sonographer
Speech-Language Pathologist (SLP)
Spiritual Care Worker
Other
Please specify your profession below.
*
What is your preferred area of interest?
*
Acute Care
Home Care
Long Term Care
Primary Care
What type of position would you be interested in?
*
Physician (Permanent)
Physician (Locum)
Associate Physician (AP)
Physician Assistant (PA)
Please choose your specialty below.
*
Anatomical Pathology
Anesthesiology
Dermatology
Diagnostic and Clinical Pathology
Diagnostic and Molecular Pathology
Diagnostic Radiology
Emergency Medicine
Family Medicine
General Pathology
General Surgery
Hematological Pathology
Internal Medicine
Medical Microbiology
Medical Oncology
Neurology
Neuropathology
Nuclear Medicine
Obstetrics and Gynecology
Ophthalmology
Orthopedic Surgery
Otolaryngology – Head and Neck Surgery
Pediatrics
Physical Medicine & Rehabilitation
Plastic Surgery
Psychiatry
Public Health & Preventive Medicine
Radiation Oncology
Respirology
Urology
Vascular Surgery
Other
Please specify your specialty.
*
What is your preferred area of medicine?
*
Addiction Medicine
Anesthesiology
Cardiology
Child and Adolescent Psychiatrist
Chronic Pain Medicine
Critical Care Medicine
Dermatology
Diagnostic Radiology
Emergency Medicine
Family Medicine
Family Practice Anesthesiology
Family Practice Care of the Elderly
Forensic Psychiatry
Gastroenterology
General Internal Medicine
General Surgery
Geriatric Medicine
Geriatric Psychiatry
Hospitalist
Immunology and Allergy
Infectious Disease
Medical Microbiology
Medical Oncology
Medical Oncology Clinical Associates
Neonatology
Nephrology
Neurology
Obstetrics and Gynecology
Ophthalmology
Orthopedic Surgery
Otolaryngology (or ENT)
Palliative Care
Pathology
Pediatrics
Physiatry
Physical Medicine and Rehabilitation
Plastic Surgery
Psychiatry
Radiation Oncology
Radiation Oncology Clinical Associates
Reproductive Endocrinology and Infertility
Respirology
Rheumatology
Sports Medicine
Urology
Vascular Surgery
Other
Please specify your preferred area of medicine.
*
Are you a student?
*
Yes
No
Are you a medical resident?
*
Yes
No
What program are you enrolled in?
What is your educational institution name?
Algoma University
Algonquin Careers Academy
Algonquin College
Anderson College of Health, Business and Technology
Assiniboine Community College
Athabasca University
Aurora College
Bow Valley College
Brandon University
British Columbia Institute of Technology
Brock University
Cambrian College
Camosun College
Canadian Imperial College
Canadore College
Cape Breton University
Carleton University
CDI College
Cégep de l’Outaouais
Cégep de Rimouski
Centennial College
Centre for Nursing Studies and Western Regional School of Nursing
CHN College Inc
Coast Mountain College
Collège Boréal
Collège communautaire du Nouveau-Brunswick
College de L'ile
Collège de Rosemont
Collège La Cité
College of New Caledonia
College of the North Atlantic
College of the Rockies
Columbia College
Concordia University
Conestoga College
Confederation College
CTS Canadian Career College
Dalhousie University
Dawson College
Discovery Community College
Douglas College
Durham College
Eastern College
Fanshawe College
First Nations University of Canada
Fleming College
George Brown College
Georgian College
Holland College
Humber College
Keyano College
Keyin College
King's University College
Kingston Learning Centre
Kwantlen Polytechnic University
La Cité collégiale
Lakehead University
Lambton College
Langara College
Laurentian University
Lethbridge College
Loyalist College
MacEwan University
Marguerite Connolly Training and Consulting
Manitoba Institute of Trades and Technology
McGill University
McMaster University
Medicine Hat College
Memorial University
Mohawk College
Mount Royal University
MTI Community College
National Academy of Health and Business
New Brunswick Community College
Niagara College
Nicola Valley Institute of Technology
Nipissing University
NorQuest College
North Island College
Northern Alberta Institute of Technology
Northern College
Northern Lakes College
Northern Lights College
Northern Ontario School of Medicine
Northwestern Polytechnic
Nova Scotia Community College
Okanagan College
Ontario Tech University
Oulton College
Portage College
Queen's University
Red Deer Polytechnic
Red River College Polytechnic
Renison University College
Robertson College
Saskatchewan Polytechnic
Sault College
Selkirk College
Seneca College
Sheridan College
Simon Fraser University
Sir Sandford Fleming College
Southern Alberta Institute of Technology
St. Clair College
St. Francis Xavier University
St. Lawrence College
St. Thomas University
Stenberg College
The Michener Institute of Education at UHN
Thompson Rivers University
Toronto Metropolitan University
Trent University
Trinity Western University
Université de Moncton
Université de Montréal
Université de Saint-Boniface
Université de Sherbrooke
Université du Québec
Université du Québec à Montréal
Université du Québec à Trois-Rivières
Université Laval
Université Sainte-Anne
Université Sherbrooke
University College of the North
University of Alberta
University of British Columbia
University of Calgary
University of Guelph
University of Lethbridge
University of Manitoba
University of New Brunswick
University of Northern British Columbia
University of Ontario Institute of Technology
University of Ottawa
University of Prince Edward Island
University of Regina
University of Saskatchewan
University of the Fraser Valley
University of Toronto
University of Victoria
University of Waterloo
University of Western Ontario
University of Windsor
Vancouver Career College
Vancouver Community College
Vancouver Island University
Vanier College
Westervelt College
Wilfrid Laurier University
York University
Other
Please write down your educational institution name.
What is your educational institution name for residency?
Algoma University
Algonquin Careers Academy
Algonquin College
Anderson College of Health, Business and Technology
Assiniboine Community College
Athabasca University
Aurora College
Bow Valley College
Brandon University
British Columbia Institute of Technology
Brock University
Cambrian College
Camosun College
Canadian Imperial College
Canadore College
Cape Breton University
Carleton University
CDI College
Cégep de l’Outaouais
Cégep de Rimouski
Centennial College
Centre for Nursing Studies and Western Regional School of Nursing
CHN College Inc
Coast Mountain College
Collège Boréal
Collège communautaire du Nouveau-Brunswick
College de L'ile
Collège de Rosemont
Collège La Cité
College of New Caledonia
College of the North Atlantic
College of the Rockies
Columbia College
Concordia University
Conestoga College
Confederation College
CTS Canadian Career College
Dalhousie University
Dawson College
Discovery Community College
Douglas College
Durham College
Eastern College
Fanshawe College
First Nations University of Canada
Fleming College
George Brown College
Georgian College
Holland College
Humber College
Keyano College
Keyin College
King's University College
Kingston Learning Centre
Kwantlen Polytechnic University
La Cité collégiale
Lakehead University
Lambton College
Langara College
Laurentian University
Lethbridge College
Loyalist College
MacEwan University
Marguerite Connolly Training and Consulting
Manitoba Institute of Trades and Technology
McGill University
McMaster University
Medicine Hat College
Memorial University
Mohawk College
Mount Royal University
MTI Community College
National Academy of Health and Business
New Brunswick Community College
Niagara College
Nicola Valley Institute of Technology
Nipissing University
NorQuest College
North Island College
Northern Alberta Institute of Technology
Northern College
Northern Lakes College
Northern Lights College
Northern Ontario School of Medicine
Northwestern Polytechnic
Nova Scotia Community College
Okanagan College
Ontario Tech University
Oulton College
Portage College
Queen's University
Red Deer Polytechnic
Red River College Polytechnic
Renison University College
Robertson College
Saskatchewan Polytechnic
Sault College
Selkirk College
Seneca College
Sheridan College
Simon Fraser University
Sir Sandford Fleming College
Southern Alberta Institute of Technology
St. Clair College
St. Francis Xavier University
St. Lawrence College
St. Thomas University
Stenberg College
The Michener Institute of Education at UHN
Thompson Rivers University
Toronto Metropolitan University
Trent University
Trinity Western University
Université de Moncton
Université de Montréal
Université de Saint-Boniface
Université de Sherbrooke
Université du Québec
Université du Québec à Montréal
Université du Québec à Trois-Rivières
Université Laval
Université Sainte-Anne
Université Sherbrooke
University College of the North
University of Alberta
University of British Columbia
University of Calgary
University of Guelph
University of Lethbridge
University of Manitoba
University of New Brunswick
University of Northern British Columbia
University of Ontario Institute of Technology
University of Ottawa
University of Prince Edward Island
University of Regina
University of Saskatchewan
University of the Fraser Valley
University of Toronto
University of Victoria
University of Waterloo
University of Western Ontario
University of Windsor
Vancouver Career College
Vancouver Community College
Vancouver Island University
Vanier College
Westervelt College
Wilfrid Laurier University
York University
Other
Please write down your educational institution name for residency.
What is your anticipated graduation date?
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