Doctors Manitoba | Sick Note Think Tank Registration Form

Title *

First Name *

Last Name *

Title *

Please indicate your preferred title, if you selected “Other”

Phone Number *

Email *

Are you representing: *

Workplace or Organization *

Briefly describe your concerns about sick notes and other requests for medical expertise or certification.

Space is limited and we will seek to include a representative cross section of different stakeholder groups.

This workshop will be primarily an in-person event, However a Zoom-based option will be offered for those outside of Winnipeg unable to attend in person to allow them participate remotely.

If selected, do you plan to attend in person or remotely: *

In-Person

Remote

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Sick Note Think Tank Registration Form