HomeOsteoporosis and Fracture Prevention Workshop Form

Osteoporosis and Fracture Prevention Workshop Form

March Workshop Form

Workshop date and time: March X from 1 p.m. - 4 p.m.

Visit the workshop page for more details .

Name(Required)

First Last

Email(Required)

Mobile phone (we’ll only contact you if necessary, regarding this course)(Required)

Province(Required)

Postal Code

Region (if you are of outside Ontario, select "other")

Practice Model(Required)

Specify Practice Model(Required)

Clinical Interest (optional)

Registration Fees (Member & Non-Member)(Required)

To be eligible for the member price, you must be a current member of the Ontario College of Family Physicians (OCFP). Please provide your CFPC number to verify your membership status.

Workshop price includes applicable taxes (HST).

Provide your CFPC # (earned credits will be directly entered into your Mainpro+ account). Hint: your CFPC is 6-digits and starts with a “6” or "7"(Required)

Payment method(Required)

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Do you wish to receive updates from the OCFP?

How did you hear about this workshop?

Comments

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