Interprofessional Core Curriculum
an interprofessional workshop
Strategies to Support Cancer Patients and Family Members
The How and Why of Assessing and Referring Patients to Practical, Physical and Emotional Supports and Resources
an interactive and interprofessional education workshop designed to improve collaboration and communication among healthcare professionals who care for patients living with cancer. Wednesday, May 27, 2009 – 4:00 – 7:30 PM Capital District Health – QE II - VG Site – Bethune Room 544 Please arrive 15 minutes prior to start time of the workshop.
Facilitators:
Janet Rhymes, BEd, MA, Dip Adult Ed Corrie Melanson, BA, Dip Adult Ed This is a pilot program, part of the Partners for Interprofessional Cancer Education (PICE) project, funded by Health Canada. Space is limited - please register early. To register: Fax the registration form on the back of this page to Cancer Care Nova Scotia at 902-473-6412, Attention: Allison MacDonald. Registration form is also available at: www.cancercare.ns.ca
Strategies to Support Cancer Patients and Family Members Capital District Health – VG Site – Bethune Room 544 Wednesday, May 27, 2009, 4:00 – 7:30 PM
REGISTRATION FORM
PLEASE PRINT CLEARLY (Note: We are unable to process illegible or incomplete forms) Name: _____________________________________ Email ________________________________ Work Address: Hospital/Facility Name ________________________________________________ Department___________________ Unit __________ Floor _____ Street Number ______________ Street Name ________________________City ___________________ Postal Code ____________ Phone: (W) (____) _______________ (H) (_____) _____________ Fax: (____) _______________
Please check one: Family Physician Physician Specialist – please specify _____________________________________ Nurse – please specify ________________________________________________ LPN – please specify _________________________________________________ Social Worker Spiritual Care/Chaplain Pharmacist Dietitian Other – please specify _________________________________________________ I work in a: Community setting Hospital setting Long-Term Care setting
Space is limited – please register early.
To register: Please fax this form to Cancer Care Nova Scotia at 902-473-6412, Attention: Allison MacDonald. CCNS collects and uses your above information for administrative purposes related to this session. CCNS retains this information for follow-up with participants (this may include contacting you for research and evaluation purposes) and to keep a history of an individual’s participation in CCNS educational programs. CCNS does not use or share any individuals information for other purposes without obtaining the individuals consent. CCNS Privacy Statement is available on our website. This is a pilot program, part of the Partners for Interprofessional Cancer Education (PICE) project, funded by Health Canada.