Registration for Advance Care Planning Workshop

Thank you for your interest in this event/program. Please complete and submit the form below.

Timeslot:

Wednesday 16th Apr 2025, 1:30pm - 3:00pm

Location:

Bathurst
440 Bathurst Street - 3rd Floor Toronto ON

Availability:

20 spaces remaining

Name:

Date of Birth:

Email:

Confirm email:

Phone Number:

Are You a Patient of Toronto Western Family Health Team?:

How Did You Hear About this Program/Workshop?:

Important:

By registering for this workshop, I understand and agree that:

I am registering to participate in a live video-conference patient and caregiver workshop/presentation for the purpose of learning (and not for medical treatment)
My voice and image will be shown on the screen if I choose to speak/participate during the videoconference
My name will be shown on the screen as it appears on my MS teams account
E-mail communications over the internet are not secure and there is a risk that e-mail can be intercepted and read by other parties. By providing your email address you accept this risk.

Do you agree to the above statement(s)? Yes