"*" indicates required fields EMPATHY EFFECT: COUNTERING BIAS TO IMPROVE HEALTH OUTCOMESUpcoming WorkshopsAll workshops being offered virtually through ZoomTraining Date Join wait list Name* First Last Name of Organization* Organization Position Professional Designation Phone*Email* Mailing Address* Please list where you would like your materials package shippedFollow Up Attendance confirmed Please confirm that you will be attending the follow up sessionHow would you like to be contacted?* Phone Email Food allergy? Participants will receive a snack with their materials package. Please let us know if you have a nut allergy/food restriction.What is your your preferred language? If your preferred language is not English or French which of Canada’s official languages are you most comfortable using? English French How did you hear about this workshop?EmailNewspaper AdPosterRadioReferral from a Friend/Family MemberReferral from a Healthcare ProfessionalSocial MediaTelevisionThis WebsiteOtherPlease specify how you heard about us Newsletter Signup I would like to be added to the newsletter contact list. HiddenSubmission Date MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Interested in becoming a facilitator? Get Involved
