Registrant Enrollment Form

Support on Therapeutic Prescribing Data Collection

This form allows registrants of the College to enrol in a free support program from the College of Naturopaths of Ontario in the collection of their data relating to the Standard of Practice on Therapeutic Prescribing.


How it Works


Registrants are invited to complete this enrollment form. Once signed and submitted, the College will send you a unique link to your own personalized data collection form.


Using that unique link, enrolled registrants can submit their data from their individual practice using this form. Over the course of the year, Registrants submit their data on their own pre-determined schedule and the College will tabulate the data on their behalf.


At the end of the calendar year, the College will automatically send the data collected over the past year to each participating Registrant using an automated process. Registrants can then formally submit their data to the College on the required form.


PLEASE NOTE: The College will not automatically take the data from this process over to the formal reporting process. This allows for registrants to check the quality of the data. The data collected will be deleted 3 months after each collection period and will not be retained by the College.

About You

Please enter your first name as it appears on the public register of the College.

Please enter your middle name as it appears on the public register of the College.

Please enter your last name as it appears on the public register of the College.

Please enter your College registration number. Please be sure to enter the correct information as this will be the mechanism used by the College to sort all data.

Please enter the email address you wish to use for this program.

Enrollment Information

Please enter the date you are enrolled in this program.

Submission Frequency*

Please indicate how frequently you will be submitted your data.

Reminder Request*

Please indicate whether you would like an email reminder to submit your data based on the frequency noted above.

Support Community

Given that this is the first time this data is being collected, the College realizes that there will be many questions as things move along. To provide further assistance, the College is launching a support community through our Basecamp collaboration. Within this community, you will be able to post messages on the Message Board for other community members and College staff to respond and provide support and answer questions you may have. We will also post many of the questions and answers from the In Conversation With held on December 18, 2024.

Would you like to enroll in the College's Support Community offered through Basecamp?*

If you choose to do so, you will receive a separate invitation from the College's BaseCamp account to join.

Declarations & Signatures

Declaration*

I declare that the information I have provided on this form is accurate to the best of my ability. I also declare that I am entering into this program voluntarily and that I will be responsible for the submission of final data collection totals to the College.

Signature


By checking the box below, you are affixing a signature to this form and indicating that this form and the information contained herein is bound directly to you.

COPY OF SUBMISSION

Below is a check box to enable you to receive a copy of your submission. It is highly recommended that you check this box and enter your e-mail address. This will enable the on-line system to send you a copy of the information that you have provided to the College.

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