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Ontario Provincial Wait List

Please enter your information to place your name on a wait list for the next session to be scheduled in your region. PLEASE NOTE: Personal Support Wokers are not eligible for this program. Please go to http://u-first.ca for more information.

Participant Information

First Name
Last Name
Email Address
Phone Number

Senior Leader/Manager to whom you report:

First & Last Name:
Email Address:
Phone Number:

Organization Information

Organization Name:
Organization Address
City/Town:
Postal code:
Organization Phone #:

What is your position within the organization?

Job Title

What is your professional designation?

RN
RPN
Social Worker
Occupational Therapist
Physiotherapist
Recreation Therapist
Other, please specify:

Are you aware of the performance objectives for this P.I.E.C.E.S. education program?

Yes
No