Register As Member Clinician Care Partner By registering with AVOID you will be granted access to our member only content. You may need to check your spam/junk mail for the registration email if it doesn't show up after a few minutes. If you still don't get the email, please contact dwt@ualberta.ca, hollycfncha@gmail.com. If completing the online registration or healthy aging assessment presents any challenges for you (such as vision problems, or an unsteady hand), program administration can complete it on your behalf over the phone. Please call 613-549-6666. Ex. 2834 to organize this.Name(Required) First Last Username(Required) Email(Required) Password(Required) Enter Password Confirm Password Phone Number(Required)Practice(Required) Role(Required) Your Age(Required)Age of Loved One(Required)How did you hear about the AVOID Frailty program?(Required) Canadian Frailty Network website Poster, flyer, or pamphlet at community venue Newspaper Magazine or Newsletter Healthcare practitioner Social media Word of mouth Event Radio Mail Television Bus ad Other If you remember the location/event, please specify Please specify platform(Required) Facebook Twitter LinkedIn Other Access to AVOID Frailty HandbookWe have an AVOID Frailty Handbook that will explain the program, help you navigate the website, and troubleshoot any problems you run into. How would you like to receive it? Electronically via email Paper copy in the mail I do not want the handbook Please Specify Mailing Address:(Required) Was this program recommended by a Queen's Family Health Team Community Service Worker? Yes No Participant Demographic QuestionnaireWhat are the first three digits of your postal code (e.g. K7P)?(Required) What is your gender?(Required)Gender refers to social roles and expectations, behaviors, expressions, and identities of girls, women, boys, men, and gender-diverse people. Man Woman Nonbinary Prefer to self describe myself Sexual Orientation(Required)Which of the following best describes your sexual orientation? Straight or Heterosexual Gay or Lesbian Bisexual Other Which category(ies) best describes you? Check all that apply:(Required)In our society, people are often described by their race or racial background. These are not based in science, but our race may influence the way we are treated by individuals and institutions, and this may affect our health. Black East Asian Indigenous (First Nations, Inuk/Inuit, Métis) Latin American Middle Eastern South Asian Southeast Asian White Another race category I don't know Prefer not to answer Do you identify as First Nations, Inuk/Inuit, and/or Métis? Check all that apply:(Required) Yes, First Nations Yes, Inuk/Inuit Yes, Métis No I don't know I prefer not to answer
