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Family Physician-Administrative Leadership Partnership Registration

Welcome to the OCFP Family Physician-Administrative Leadership Partnership Registration Form

Thank you for your interest in the OCFP Family Physician–Administrative Leadership Partnership. This innovative program is designed to enhance healthcare leadership by fostering strong, collaborative relationships between family physicians and administrative leaders through a dyad model. For program details, visit our website.

Important: This program is open to family physician–administrator pairs. If you're unsure whether this program is the right fit for you and your partner, please contact Sacha Roman at sroman@ocfp.on.ca for more information.

Please complete the form below.

Participation Confirmation

Please confirm both dyad partners will be available for the full duration of this in-person program by checking the box below:(Required)

Yes, both partners are available to attend on October 30, 31 and November 1, 2025 (2.5 days in person program)

Dyad Partner Information

Please provide the following details for both members of your dyad team:

Family Physician Details - Name(Required)

Email(Required)

Job Title(Required)

Administrative Lead Details - Name(Required)

Email(Required)

Job Title(Required)

Practice Information

Identify your Ontario Health region:(Required)

Identify your practice model:(Required)

Please specify practice model:(Required)

Employer:(Required)

Payment Details

A single payment will be processed for both dyad partners.

Program: Family Physician–Administrative Leadership Partnership - October 30, 31 and November 1 2025

Price:

Total includes $600 + HST per person; HST included in total.

Payment Method(Required)

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Let us know which email address you'd like us to send your confirmation to:(Required)

How did you hear about this program?

Other (please specify)

Cancellation Policy:

The OCFP reserves the right to cancel sessions due to unforeseen circumstances or insufficient advance registration. In the event of a cancellation made by the OCFP, a full refund will be given to the registrants. However, the OCFP cannot accept responsibility for out-of-pocket expenses due to cancellation of a session. Cancellations made more than 15 business days prior to the date of the event will be refunded, less a 25% administration fee. No refunds will be provided after this deadline.

Name

This field is for validation purposes and should be left unchanged.