Canadian Social Prescribing Community of Practice for Practitioners - Registration Form

This Community of Practice (CoP) registration form is intended for social prescribing practitioners who are actively involved in the implementation and delivery of social prescribing services across Canada. By joining this CoP, registrants will engage with fellow practitioners to share insights, exchange best practices, and collaborate on overcoming challenges. The community aims to foster professional development, enhance expertise, and support ongoing learning and innovation in the implementation of social prescribing.

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* 1. Contact Information

Name

Job Title

Organization

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* 2. Geography (Organization/Site)

Postal Code (no space)

Province

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* 3. Which best describes your role in social prescribing?

Connector/Link Worker

Project Manager/Lead/Staff

Researcher and evaluator

Healthcare practitioner

Community 'prescription' provider

Organizational executive

Funder

Other (please specify)

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* 4. Please describe briefly your social prescribing initiative, project, and/or collaboration (~ 100 words)

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* 5. Please rank your how important the following aspects of a CoP are to you

	Not important	Somewhat important	Very important
Discuss challenges and solutions	Discuss challenges and solutions Not important	Discuss challenges and solutions Somewhat important	Discuss challenges and solutions Very important
Knowledge sharing	Knowledge sharing Not important	Knowledge sharing Somewhat important	Knowledge sharing Very important
Access to resources/tools	Access to resources/tools Not important	Access to resources/tools Somewhat important	Access to resources/tools Very important
Collaboration on local projects	Collaboration on local projects Not important	Collaboration on local projects Somewhat important	Collaboration on local projects Very important
Collaboration on national projects	Collaboration on national projects Not important	Collaboration on national projects Somewhat important	Collaboration on national projects Very important
Networking and community building	Networking and community building Not important	Networking and community building Somewhat important	Networking and community building Very important
Professional Development	Professional Development Not important	Professional Development Somewhat important	Professional Development Very important
Opportunities to share my SP work	Opportunities to share my SP work Not important	Opportunities to share my SP work Somewhat important	Opportunities to share my SP work Very important
Opportunities for leadership	Opportunities for leadership Not important	Opportunities for leadership Somewhat important	Opportunities for leadership Very important

Canadian Social Prescribing Community of Practice for Practitioners - Registration Form

Question Title

* 1. Contact Information

Question Title

* 2. Geography (Organization/Site)

Question Title

* 3. Which best describes your role in social prescribing?

Question Title

* 4. Please describe briefly your social prescribing initiative, project, and/or collaboration (~ 100 words)

Question Title

* 5. Please rank your how important the following aspects of a CoP are to you

Question Title

* 6. Please share any additional comments