British Columbia Patient Empowerment Meeting
The Canadian Fabry Association (CFA) is hosting a Patient Empowerment Workshop for patients living in British Columbia. Please RSVP by October 1st, 2019.

DATE: October 19th, 2019
TIME: 9:00am – 3:30pm (Time subject to change)
LOCATION: Pinnacle Hotel Harbourfront, 1133 West Hastings Street, Vancouver, BC


ACCOMMODATIONS:

Accommodations will be covered for patients and their families if your commute is more than 2 hours, or if you are flying in for the Patient Empowerment Workshop. If you are driving 2 hours or longer, the CFA will reimburse you 35¢/km (please print out a google map and submit mileage at the conference)


MEALS:

A light breakfast, hot lunch, and afternoon break will be served throughout the workshop.


TRANSPORTATION:

We will reimburse pre-approved mileage, bus fare, train, and parking for qualified participants. For patients and families requiring flights, the CFA will arrange flights and will reimburse pre-approved transportation costs associated with getting to and from airports.

Deadline: October 1st, 2019

Thank you, we look forward to spending the day with you.

First Name *
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Last Name *
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Email Address *
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Home Address *
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Phone Number *
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How many people, including yourself, will be attending the Patient Empowerment Meeting? *
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Participant # 2 - First and Last Name
Your answer
Participant # 3 - First and Last Name
Your answer
Participant # 4 - First and Last Name
Your answer
Participant # 5 - First and Last Name
Your answer
Do you have children attending? *
Name and age of 1st Child
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Name and age of 2nd Child
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Name and age of 3rd Child
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Please click on an option that best describes you: *
Do you, or anyone in your party have accessibility or special accommodations? If yes, please include the details of the accommodation
Your answer
Do you require hotel accommodations (if you are flying in or travelling 2 hours or more) *
How many rooms are required
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If you are flying, what is your preferred date and time of departure, and what airport are you departing from?
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Date and preferred time from Vancouver to home
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Do you, or anyone in your family have food allergies/intolerances that we need to be mindful about? If yes, please list the allergy/intolerance and we will do our best to accommodate.
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Fill in the blank with a positive empowering word that describes you and anyone you are registering - I AM.... (for example: brave, fearless, courageous, resilient...etc.) *Ensure you complete this for all members of your party joining you. They will be used on our name tags when you sign in. *
Your answer
Empowerment word for 2nd person - I AM ?
Your answer
Empowerment word for 3rd person - I AM ?
Your answer
Empowerment word for 4th person - I AM ?
Your answer
Do you have anything else about you or your family that you would like us to know?
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