suggest_topic

Topic Suggestion Form

The Canadian Task Force welcomes all topic suggestions dealing with preventive health issues. If you have a topic you believe the CTF should review or a topic already reviewed by the CTF that should be updated, please fill out the following form. Click on "Submit Form" when done.

1. User Information:

a. Please select the option that best describes you:

Primary Care Physician

Primary Care Nurse

Specialist Physician - Please specify:

Other Clinician or Health Care Professional - Please specify:

Health Care Planner or Policy Maker

Patient/Health Care Consumer

Member of the Public

b. What is your current geographic location?

Alberta	Nova Scotia	Saskatchewan
British Columbia	NWT	Yukon
Manitoba	Ontario	United States of America
New Brunswick	PEI	Other
Newfoundland	Quebec

c. Contact Information (optional):

(This information will allow the CTF to follow-up on any suggestions.)

Name:
Email Address:
Address:
City:
Province / State:
Country:
Postal / ZIP Code:
Phone Number:
Fax Number:

2. Topic Suggestion

a. Topic to suggest (click in box below to enter suggestion):

b. Is this a new topic or an update of a topic previously reviewed by the CTF?

New Topic

Update

c. Why do you think the CTF should review this topic?

d. Other comments:

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