Registration: VCH/PHC PQI L2 Intermediate Training
For help contact: rochelle.szeto@vch.ca

After completing this registration form, you will be sent a meeting invite to hold the time in your calendar. Please email Rochelle at Rochelle.Szeto@vch.ca if your availability changes and you are no longer able to attend.
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First Name *
Last Name *
E-mail *
Phone Number
What is your Specialty *
In which Community of Care, do you mostly work? (Select Primary) *
Register for Training (multiple answers accepted) *
Required
If you are a physician, please enter your home address to receive JCC-rate funding. We cannot reimburse you without it.

Please enter it in the format: Street Address, City, Province, Postal Code. *
If you are a physician, please provide your MSP Number and whether you are salaries or FFS.

If you are a non-physician, please enter your title.  

If you are a project team member, please enter your title and the name of PQI Physician Lead.
Please note: Funding for physicians is one-time only. If you have taken Level 2 in the past, you may choose to take a refresher, but you will not be eligible for funding
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