Text size
Menu
Home / Education/ Practising Well/ Peer to Peer Connect/ Peer Guide Application Form

Peer Guide Application Form

Image of two people talking

Interested in being a Peer Guide for Practising Well? Here’s what you need to know and your next steps.

Practising Well Peer Guides are family physicians who want to share their experience and expertise in mental health, substance use disorders and/or chronic pain – both one-on-one with individual learners and more widely, including through the Practising Well Community of Practice and Information Exchange.

Before you apply, we want to ensure you have the information you need about the role.

If you haven’t already done so, please read the Peer Guide role description and/or contact us with your questions. We’ll invite you to join us at an upcoming Peer Guide information session.

Let’s get started…

Personal Information

Your Personal Information - Please provide your contact information below.

Required Qualifications

Required Qualifications - Please check all that apply.

Years in Practice

Years in Practice

Preamble text to practice location and practice model

OCFP programs strive to represent the full range of our membership, including all practice types and regions of the province. Please tell us your location and your practice type.

Practice Location

Your Practice Location - Please select all that apply.

Practice Model

Your Practice Model  - Please select all that apply.

Preamble text to experience and expertise

Your answers to the following questions will help determine your interest and expertise in mental health, substance use disorders and/or chronic pain. You do NOT need to be an expert in all three topics to be a Peer Guide.

Mental Health

Clinical Experience and Expertise

Please describe your expertise in the area of mental health on a scale of 1 to 5:

Substance Use Disorders

Please describe your expertise in the area of substance use disorders on a scale of 1 to 5:

Chronic Pain

Please describe your expertise in the area of chronic pain on a scale of 1 to 5:

Theoretical and Practical Knowledge of Mentoring and Coaching

Please describe your theoretical knowledge of mentoring and coaching on a scale of 1 to 5:

Reason for applying
Captcha