Educating Family Physicians in Palliative Care - Fall 2025

Nurse Practioner Registration

Contact Information:

* Denotes a mandatory field

*First Name:

*Last Name:

*Title:

* Company/Organization:

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City:

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*Postal/Zip Code:

*Telephone:

Extension:

*Email Address:

Event-Related Questions

*I would like to receive notification about programs through the CPD newsletter

*How did you hear about the program?

If other, please specify

In order to better address your learning needs, please identify three practice questions you have pertaining to the topic of this CPD event. These questions will be provided to speakers in order to inform the content of their sessions.

Please let us know if you have any dietary restrictions or preferences that we should be aware of for catering purposes.

We’re committed to making our programs inclusive and accessible. Using the space below, please indicate any accommodations you may need—such as for nursing, faith-based observances, or accessibility—to fully participate.

*I understand that this program is designed for Family Physicians and that as a Nurse Practitioner I am not eligible to complete the preceptorship nor receive any financial support to cover expenses.

Yes

*Queen's University's Collection Notice

Personal Information is collected under the authority of the Queen’s University Royal Charter, 1841 , as amended, 
and will be used for the registration and associated uses for attending/registering for Educating Family Physicians in Palliative Care - Fall 2025. 
Questions regarding the collection or use of this personal information should be directed to cpd.team@queensu.ca. 

By clicking 'Yes' you agree to the collection of this information.

yes

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