Making Sense of Pain new site application

Thank you for your interest in offering Making Sense of Pain in your community! Please complete the following form with as much information as you know about your site and someone from the Pain BC team will contact you in 5-10 business days to follow up. If you have questions about this application, please contact us at education@painbc.ca

Yes, I have read through the Making Sense of Pain program description.

https://painbc.ca/making-sense-of-pain

Your name

Email address

Phone Number

Organization name (e.g. Main Street Health Centre)

City

Province or Territory

Have you/your organization run Making Sense of Pain in the past?

Yes

Which version of Making Sense of Pain were you hoping to run for your first cohort?

In Person

Online

Hybrid

Pain BC/Pain Canada can offer different levels of support to Making Sense of Pain sites. Please select the items you can pay for when running your MSOP site

Pain BC/Pain Canada cannot provide facilitators or venues but If your organization cannot pay for a facilitator, Pain BC/Pain Canada may be able to cover the wages. Alternately, we can assist sites with securing funding.

We have identified a facilitator and we can pay for their training time.

We have identified a facilitator and can pay for their program delivery time.

We can pay to print program materials

We can pay to provide food/catering/ gift cards

We can pay for participant accessibility subsidies (childcare, travel etc.)

We can pay for venue rental or zoom account for online facilitation

How many participants do you anticipate enrolling in this program? If unknown, leave blank.

Note: We recommend a max of 10 participants per program.

What is your anticipated start date for Making Sense of Pain? If unknown, leave blank.

Note: Pain BC/Pain Canada requires at least 3 months lead time for any new sites.

Additional comments about funding/costs for the site

Have you identified a facilitator who can run the program?

Is there anything else about your site that you would like us to know?

Send me a copy of my responses

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