For this ECHO Program, some additional information is required by our funder. Your name is used just for sign up, and will not be shared. *

Space is limited within this ECHO Program, so we ask that you sign up with the intent to attend the majority, or all of the sessions. Also, please be on the lookout for a Pre-ECHO Survey from our Research Coordinator, Donna Garstin in the coming days. Thank you!

First Name

Last Name

How knowledgeable are you about chronic pain management?

1 - Not knowledgeable at all

2

3

4

5

6

7 - Extremely knowledgeable

How knowledgeable are you about the history of Indigenous Peoples in Canada?

1 - Not knowledgeable at all

2

3

4

5

6

7 - Extremely knowledgeable

Would you like to self-identify as Indigenous (First Nation, Inuit, Métis)?

Yes

I am not Indigenous

Prefer not to answer

Unable to answer

Do you have an Indigenous patient with chronic pain concerns, who you could discuss on one of the following session dates?

Jan 17

Jan 24

Jan 31

Feb 7

Feb 14

Feb 21

Feb 28

Mar 7

Mar 14

Mar 21

Consent to Participate in Program Evaluation (Click Here For Details) *

I consent to receive a Pre- and Post-ECHO survey

I do not consent to participate in a Pre- and Post-ECHO survey