Visual Perceptual Dysfunction Post-Stroke Workshop

'Visual Perceptual Dysfunction Post Stroke: Assessment and Management' Workshop
to be held at Elisabeth Bruyère Hospital, 6th floor Le Jardin conference room
43 Bruyère St, Ottawa
Wednesday, October 2, 2019 from 8:30-4:30
Lunch will be provided
Registration Fee $60
Priority registration will be given to healthcare providers working with stroke survivors in the Champlain Region.

Please supply the registrant's First name

1st (or given) name of person being registered

Please supply the registrant's Last Name

Last name of registrant

Please supply your email address

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Please fill in your work phone number, including area code. Please use only numerals, not "-" or".",
Do not use any characters like "X" or "x"

Usual daytime phone number. Please list extension in the next field. Please enter numbers only, no letters, spaces, dashes or symbols

Enter the number of your extension, numerals only please, no symbols or special charcters

Phone Extension if needed


Please select the name of your organization

Name of the organization, business, or hospital registrant works for. Please be sure to CLICK on your selection

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If the person being registered does not work on a formal stroke unit within the CRSN, please choose "Not Applicable"


Please supply the name of your Manager or Scheduler

Please provide the first name of Manager, Shift Scheduler, or Edu Coordinator

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Please provide the last name of Manager, Shift Scheduler, or Edu Coordinator

Please supply your manager's email address or phone number

Email of Manager listed above



The CRSN invites health care professionals who work within the Continuum of Stroke Care and are situated within the Champlain Region to participate in educational events dedicated to best practices in Stroke Care.

All information gathered in this form is done so in confidentiality, and will not be used for purposes other than for the explicit event for which data is being gathered.
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