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Registration for Asthma in Children
Thank you for your interest in this event/program. Please complete and submit the form below.
Timeslot:
Wednesday 29th Mar 2023, 3:00pm - 4:00pm
Location:
* Virtual Mtg *
Availability:
42 spaces remaining
Name:
Date of Birth:
Email:
Confirm email:
Phone Number:
Are You a Patient of Toronto Western Family Health Team?:
Select...
Yes
No
How Did You Hear About this Program/Workshop?:
Select...
Newsletter
TW FHT Staff
Word of Mouth
Email
Social Media
Website
Other
Important:
By registering for this workshop, I understand and agree that:
I am registering to participate in a live video-conference patient and caregiver workshop/presentation for the purpose of learning (and not for medical treatment)
My voice and image will be shown on the screen if I choose to speak/participate during the videoconference
My name will be shown on the screen as it appears on my MS teams account
E-mail communications over the internet are not secure and there is a risk that e-mail can be intercepted and read by other parties. By providing your email address you accept this risk.
Do you agree to the above statement(s)? Yes