Canadian Hospice Palliative Care Association > Conference > Registration Registration Required Fields show an asterisk (*) Please select which stream you wish to participate in:*No Stream SelectionStream 1: Communication in Serious Illness: An innovative approach to clinical care and quality improvementStream 2: Psychosocial LearningStream 3: ACP in Canada: New Tools in Community CareStream 4: Compassionate Leadership and Compassionate Communities – where do we go from here?1/2 Day Stream (Applies to Stream 1 and 3 Friday AM session only): Serious Illness Conversation Clinician WorkshopExhibitor OnlyCHPCA Learning Institute will be offering a Stream dedicated to Communication in Serious Illness. There will be an opportunity for selected participants to attend this session. To apply to attend this session please fill out the application form and submit. Applications will be reviewed the week of October 15th, 2020. Go to Stream 1 Application Form I have been accepted to attend Stream 1: Serious Illness Conversations and wish to register for the Learning Institute*YesNoOnly individuals whose applications have been accepted are eligible to register for this stream.If you have not been accepted to attend Stream 1: Communication in Serious Illness: An innovative approach to clinical care and quality improvement, please fill out the application form and you will be notified of your acceptance into the Stream. Please select your first choice session for Stream 1: Day 2Serious Illness Conversation Clinician Workshop (Limited Space Available)Adaptations to the Serious Illness Conversation Guide: Exploring Serious Illness Conversations Acceptability within all Canadian Populations Please note: space within the Serious Illness Conversation Clinician Workshop is limited. New facilitators from Day 1 will have an opportunity to teach the Serious Illness Conversation Clinician Workshop. Priority would be given to those who have completed or attended Day 1, and particularly to those participants without access to attend a clinician workshop within their geographic regions. Participants will be notified about which session they have been selected to attend in October. On Friday, November 13, 2020, Stream 1 and 3 will be participating in the following session. This session is open for all to attend, however, priority will be given to full Stream 1 and 3 registrants: Serious Illness Conversation Clinician Workshop For more details about this session, please view the Learning Institute program. Click here to be directed to the Learning Institute Program Please Select Registration Type:*Non-Member ($475)Member ($400)Please Select Registration Type:*ExhibitorExtra Exhibitor ($100)Please Select Registration Type:*1/2 Day Stream (For Stream 1 and 3 only) ($250)Promo Code: Total $ 0.00 CAD CHPCA Membership ID (required only if claiming a membership discount):*For information on obtaining membership number please contact firstname.lastname@example.org.Name:* First Last Organization:Email:* Profession:*AdministratorClinical Nurse SpecialistDoctorEducatorNurse ManagerNurse PractitionerOccupational TherapistPalliative Care CoordinatorPersonal Support WorkerPharmacistPhysiotherapistRegistered NurseRegistered Practical NurseResearcherSocial Worker/CounselorSpiritual AdvisorStudentVolunteerVolunteer CoordinatorOther (please specify)Please Specify Profession:*Address* Street Address Address Line 2 City Province / State / Region Postal / Zip Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone:*How did you hear about the Learning Institute?*Aviso (CHPCA newsletter)CHPCA monthly updateEhospiceCHPCA websiteCHPCA EmailFacebookTwitterFirst announcement flyerProvincial organization updateOtherI will be attending the Opening Plenary Thursday, November 12, 2020 (Included with registration fee):*YesNoI have read and understand the CHPCA Learning Institute's Registration Cancellation Policy:* Yes View Cancellation Policy I do not wish to be included on the Learning Institute participant list I do not wish to receive communication from the CHPCA Payment:*Pay by Credit CardPay by ChequePlease make cheque payable to “Canadian Hospice Palliative Care Conference” and mail to: Canadian Hospice Palliative Care Conference Annex D, Saint-Vincent Hospital 60 Cambridge Street North Ottawa, Ontario Canada K1R 7A5 The CHPCA is pleased to offer group discounts for groups of 5 or more. 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