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Continuing Care
Edmonton Zone Palliative Care Program
Registration Information
Professional Designation:
Name:
(MD, RN, LPN, etc.)
Workplace Setting:
Employer:
(clinic, acute, homecare, etc.)
Email:
Contact Number:
Workshop Dates,
Locations & Time:
April 17, 2015
(1:00 pm – 5:00 pm)
&
April 18, 2015
(8:00 am – 4:30 pm)
Royal Alexandra Hospital
Payment Information
The workshop fee is $89.00. This fee includes workshop package and materials, refreshments served on the first half-day
session and a continental breakfast, lunch and refreshments served on the second full-day session.
Registration acceptance is dependent on payment of workshop fee.
Registration is limited to a maximum of 60 participants.
Confirmation of workshop registration will be sent via email once payment has been received.
Payment must be made via cheque only.
Please post-date your cheque to the date of chosen workshop and make payable to Alberta Health Services
Please forward your payment to:
Edmonton Zone Palliative Care Program
#335, St. Marguerite Health Services Centre – Grey Nuns Community Hospital, 1090 Youville Drive West
Edmonton, AB T6L 0A3
Please complete this registration form and email it to:
@ [email protected]
www.palliative.org
https://www.facebook.com/EZPCP