Workshop: Virtual Care in Northern Ontario First & Last Name *Please indicate where you are currently practicing. *Workshop Date *We will be offering the workshop on two separate dates. Please choose your preferred date. We will do our best to accommodate your choiceTuesday, January 12, 2021: 7pm-8pmTuesday, January 19, 2021: 7pm-8pmWhile not a requirement, we are hoping to identify a member who speaks French in order accommodate francophone patients in Northern Ontario. What is your level of proficiency in speaking French. *I am fully bilingual.I have some competency in speaking FrenchI am not proficient in speaking FrenchDo you have experience in providing virtual care using OTN? *YesNoDo you have experience working with a trained ACPAC Therapist?YesNoIs there anything else you'd like to share with us prior to joining the workshop?